COMPARISON OF BONE SCANNING AND BONE-MARROW SCINTIGRAPHY IN THE DETECTION AND MONITORING OF BONE METASTASES

The purpose of this review is to define the role of bone scanning and bone-marrow scintigraphy in the detection and monitoring of skeletal metastasis. The bone scan has remained the screening method of choice for many years, because of its exquisite sensitivity for lesion detection and its ability to evaluate the whole skeleton in one setting. Bone-marrow scintigraphy with 99mTc-labelled antigranulocyte monoclonal antibodies allows high-quality, whole-body visualization of hematopoetically active bone marrow. The importance of imaging the bone marrow is founded in the fact that, in general, bone-marrow invasion precedes skeletal involvement in the development of skeletal metastasis. The advantages and disadvantages of the two methods are compared, and the possible indications for using bone-marrow scintigraphy complementary to or instead of the bone scan are discussed.