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Neoplastic Bone Diseases

  • Chapter
Orthopedic Nuclear Medicine

Abstract

Benign and malignant primary bone tumors are rare, while metastatic disease is a common occurrence. The efficacy of the several currently available imaging modalities in the detection, staging, and follow-up of patients with skeletal neoplasia varies. Evaluation of bone tumors involves a multi-modality approach. Standard radiographs play an important role in the diagnosis of both primary and metastatic tumors. Computed tomography (CT) scan and magnetic resonance imaging (MRI) are often complementary and are particularly useful in primary bone tumors. CT scan is especially useful in evaluating the cortex. MRI is superior in evaluating the extent of several primary tumors and detecting bone marrow lesions. The role of bone scintigraphy in preoperative evaluation of primary tumors is limited. Bone scintigraphy, on the other hand, is an excellent cost-effective screening modality in detecting metastatic disease in patients with skeletal and extra-skeletal malignancies. In breast, lung, and head and neck tumors bone scan is rarely positive for metastasis in patients with low stage disease. Metaiodobenzylguanidine (MIBG) scintigraphy is valuable in children with neuroblastoma. Bone scintigraphy and other radionuclide modalities are valuable in the long-term follow up of several cancers and in estimating the prognosis. The therapeutic response of malignant bone disease can particularly be assessed using Tl-201, Tc-99m methoxyisobutylisonitrile (MIBI) and PET.

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  1. Department of Nuclear Medicine, Faculty of Medicine, Kuwait University Health Sciences Center, P.O. Box 24923, 13110, Safat, Kuwait

    Abdelhamid H. Elgazzar MD, FCAP (Diplomate, American Board of Pathology, Diplomate, American Board of Nuclear Medicine, Professor and Chairman)

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Elgazzar, A.H. (2004). Neoplastic Bone Diseases. In: Orthopedic Nuclear Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18790-2_6

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