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What is 'bone scanning'?

Bone Scanning

Hossein Jadvar (Doctor) gives expert video advice on: How can I prepare for bone scanning?; What will I experience during bone scanning?; What are the benefits of bone scanning? and more...

What is 'bone scanning'?

Bone scanning is a nuclear medicine procedure which, basically, looks at the turnover, or reaction in the bones, for a variety of reasons. We can use bone scanning to diagnose metastatic dissemination of cancer in the bone. Or use it for looking at infection of the bone, fractures. So, any disease process that involves the bone, a bone scan is useful for.

What does the equipment used in bone scanning look like?

The equipment that is used for bone scanning is basically the same as the equipment that is used in other general Nuclear Medicine areas, and in Nuclear Cardiology. They are either planar or spec systems, which have gamma camera heads, which collect the gamma rays from inside the patient, and then form an image through a computer.

How does bone scanning work?

Bone scan works through the activity of the radio tracer, Tc99m MDP, which basically collects the areas of bone formation either around tumors, infection sites or fracture sites. Basically, for example, in an area of metastases or tumor, that metastases is being contained by the normal bone around it. That bone formation or reaction is where the MDP goes and attaches itself to; therefore, it is an indirect way of looking at the tumor. In patients who have fractures, again there is healing going on in that area of the fracture by new bone formation, and Tc99m MDP goes into those areas. And that is why we are able to image areas of fracture, even earlier than what we can see with a regular x-ray. You can see the reaction much earlier. With the infection, there is a similar situation. In areas of infection the bone around the areas of infection are reacting by forming new bone and those areas where the MDP already are attracted to are able to image areas of infection.

What will I experience during bone scanning?

There is really no specific sensation that occurs during your bone scanning. A small amount of pain at the time of tracer administration intravenously, and very rare possibilities of side effects or allergic reactions that we already talked about. But other than that, there is really no specific sensation that the patient may receive during a bone-scanning procedure.

What are the benefits of bone scanning?

Similar to the other procedures in general medicine and in PET, benefits of bone scanning is tremendous, because it tells us, depending upon the what disease process that we're looking at, a good amount of diagnostic information, which is important in the care for the patient. For example, in tumour scanning, we are able to find out what the extent of the disease is to the bone from the primary tumour, and that can impact treatment to that patient. If the patient is suffering from infection in the bone, we are able to image that and treat the patient appropriately if the infection is, in fact, seen. In patients who have fractures, that also can be important for the appropriate treatment, for example, if the patient who has fractures in parts of their spine. It's also being used in child abuse cases where there are different types of fractures of varying age in children, and it can be an important part of the puzzle to see if, in fact, there has been child abuse case.

What are the risks of bone scanning?

The risk of bone scanning is basically related to the radioactivity that is administered, which is extremely small, and very similar to the other traces that are used in general nuclear medicine. With frequent voiding, and good hydration, the radiation dose to the urinary bladder, which is the major organ which receives the most of the isotope dose, in this case is diminished tremendously.