Does post treatment CT scan look at bone health?

Sydneybased

Do CT scans pick up bone issues?

suzieq60

No ,you need a bone scan for that - CT scan shows organs in the trunk

Outfield

Scans, including CT's, are protocolled depending on what they're looking for.  CT's can be done to evaluate different body parts or different tissues within the body part, including bone.  For example they're pretty good at evaluating for fractures.  They're not the best test for looking at bone for mestastatic disease.

When you say "bone health" do you mean bone density?  A scan looking for evidence of cancer doesn't evaluate bone density.

Sydneybased

I meant bone mets.... do oncologists usually send you off for a CT scan to check organs plus bones, or is the post treatment CT scan usually done to check organs alone.

Thanks!

LouLou40

I don't think it's standard practice to order post treatment ct or bone scans unless you have symptoms.

I only have a yearly mammogram and ultrasound to check my breasts and a yearly DEXA scan to check my bone mineral desity.

suzieq60

My surgeon sent me for a bone scan, a CT scan and a bone density test before I started chemo - that's when they are usually done is Australia - they never do any follow up scans unless you are symptomatic.

Sydneybased

OK thanks.

I was sent for a post treatment CT scan. Was told that it was part of the usual package of care. No symptoms presenting. It was of my pelvis, chest and abdomen. What I forgot to ask was whether it was to check out my organs plus bones, or just organs. The oncologist indicated that the scan was to set a baseline "in case I broke a bone in future and they found a nodule on an x-ray and needed to see if the nodule had grown over time." What they really meant was "we're checking you out to see if you have any spread now." I guess. Although I do appreciate the attempt to not scare patients!!

Luckily it was all clear.

suzieq60

I guess it just depends on your onc, although it would be better to know before treatment as opposed to after.

chrissilini

Yes, a CT scan can pick up bone issues. I am a CT tech. A CT scan can be of any part of the body and bone lesions or areas suspicious for mets can be seen on a scan, whether soft tissue or bone.When scanning an area of the body, say the chest, bones, organs, and other soft tissues are seen. What the scan does is takes the body part, slices it like a loaf of bread and then puts it all together to form the image. You can't scan an area without getting images of all tissues and bones in the area scanned.



A bone scan would be needed for density and that os not a CT. But, a CT most definitely can detect mets, fractures and other bone abnormalities.

suzieq60

We have separate tests here for bone density and bone scan. The bone scan involves contrast and much more radiation, whereas the bone density test doesn't.

Sydneybased

Thanks Chrissillini..very helpful.

Sydneybased

Susieq....I didn't have a CT scan before treatment. Not sure why.

Sassa

While I have periodic CT/PET scans for my BC which may detect any bone anomalies, my oncologist always wants the reports from my every other year bone density scan ordered by my PCP.  The radiologist reading the scan knows I have been diagnosed with BC and always reports if he sees any evidence of osteolytic or osteoblastic lesions on the bones. He hasn't seen any to date.

Anonymous

My oncologist just called to tell me he's authorizing a CT Scan AND a bone scan because I have an elevated CA27-29 level in my blood (whatever that is!). He was a little perturbed that my BS ordered that test pre-MX, saying it " opens Pandora's box" and worries patients needlessly....however now that the box is open, he feels there is warrant to follow up with the scan.

ElaineM

Yes it can. I once had a Cat scan guided bone biopsy.  They pushed me through the Cat scanner, located the bone they wanted to biopsy and did the biopsy right there. Try to get a 64 slice scanner.  They can see things better.

Bone scans only tell you if there is an uptake of the injection contrast. They don't diagnose the problem. An extra test like an MRI, an xray a Pet scan, a biopsy or a Cat scan may be needed after a bone scan.

ElaineM

Kicks

I had a CAT, MRI, PET and a Bone scan before starting TX. The only one of my BC Drs to have ordered another scan was Rads and he insisted on a new CAT before starting Rads. They have all 3 said anual Mammos and Surgeon and Rads have 'kicked me to the curb' - never to see them again. Still see Chemo Dr every 6 months and as he said a few weeks ago when I saw him that he'll be seeing me 'forever' as I'm high risk.



I have had some scans since end of TX that my PA ordered to check out issues - Bone Density Test, Colonoscopy, Bone Scan, Abdominal CAT, another Bone Density Test. All were done for specific reasons - not just to do another test or scan. My understanding is that for possible bone mets - you do Bone Scans. For Bone Density (osteoporosis) it's a test/x-ray that I've been doing for years.

suzieq60

Sydneybased - I just re-read your OP - if you are worried about osteoporosis then a bone denisty test is what you need. My onc ordered one for me recently but said to wait until after the end of June as apparently they will then be covered by Medicare - as I remember, it was only $75 anyway. It will be interesting to see how it's going after nearly 2 years on an AI and 4 lots of Zometa infusions.

Sydneybased

Hi Susieq58,

 I'm primarily interested in how bone mets are discovered, and whether my CT scan after treatment ticked that box.

suzieq60

Ok - then probably not - can you ask your oncologist or breast surgeon? I definitely had 2 scans one CT and one bone CT scan.

Leah_S

Sydneybased, I have bone mets that were discovered in a PET/CT. However, since that time I've had mostly CT scans to measure what's happening (so far stable, thank G-d). A CT scan would show lesions in your bones but if there is anything then a bone scan, PET scan, or MRI might be used to confirm.

So the CT scan you had did tick that box!

Leah