Which scans to diagnose bone mets

lindy123

I'm almost 3 yrs out from triple negative diagnosis, and I made an appointment with my oncologist because of hip and thigh ache/pain. She gave me a script for an MRI, but my insurance company denied it, but did approve a bone scan, which I have scheduled for monday. Which scan is better for diagnosing bone mets? Hopefully it is just bursitis or sciatica. Thank you.

Artista928

I'd go ahead with the bone scan insurance approved. I've never heard of MRI for finding bone met. When CT scan found a spot on my pelvis, MO sent me for a bone scan which showed no metabolic activity.

KBeee

Bone scans seem very common for checking for mets. Hoping for good news for you

jillts

I just had a CT scan which showed several spots on spine, pelvis, ribs, etc. I was told that my bone scan was clean (not by my onc but by the doctor who did my bone biopsy. I have not seen my onc yet as we are awaiting results of biopsy) so I gather that the CT scan is the most sensitive and picks up things that a bone scan may not. I have no idea about whether or not MRI is usually done for bone mets..

Artista, any idea what the spot on your pelvis is speculated to be? Whatever it is, I hope mine are that too.

Lindy, saying a prayer for you that it is indeed something else!

Artista928

Jillts: The exact words on my CT scan for what they saw on my iliac bone: Tiny focus of nonspecific sclerosis in the left iliac bone. My spine also showed osteophytes all over, so another non cancer thing. My MO told me there are many little bumps and odditites that can be on a bone that not to worry before I had my bone scan results. On my bone scan it said no metabolic uptake on my illiac bone.

I had a CT scan first as she wanted a baseline of what my chest and abdomen area showed (anything suspicious) before I started chemo. CT scan is like a picture as it's really a bunch of xrays that are taken, it doesn't show metabolic activity to tell really if there's really a concern or not. She's not going to monitor the illiac bone anymore since it was negative on the bone scan. Bone scan is better for monitoring for bone mets than CT scan, a picture.

As for what's a better scan.. who knows. I've heard PET can pick up many very small suspicious abnormalities that other scans can't. I have a 6 mm lung nodule though that a PET scan wouldn't be able to pick up. I don't know how common it is for MRI to be done on bone. MRI is used a lot for soft tissues like muscles and tendons. Part of what scan is chosen could be an insurance coverage thing. I've heard people say CT scan approved but not PET scan and you wonder why. Not sure even docs know what is best, if there really is a better scan but definitely for cancer a scan that shows metabolic activity it the best as that means something is going on as opposed to just a picture showing something that could very well be benign.

jillts

Artista, thanks for all that good information. The wording on my CT scan report was pretty definitive for metastasis so I don't know why I'm holding out hope. I guess there's always a small chance that the biopsy will prove something else.

Artista928

I hope it's not bone mets for you. I know the feeling on the unknown as I await to get a follow up CT scan on a lung nodule that showed up after sx. Even if it is, there are now so much tx available and so many people I see around here go years on tx and do very well. I wish you well.

jillts

Thank you, Artista. Wishing you the same for your follow up scan.

vlnrph

Have not seen our original poster Lindy return here so hope she is handling whatever news was received.

Bone scan uses radioactivity to pick up signs of unusual activity and is best for finding skeletal metastases. PET looks for cells using higher amounts of sugar/glucose to fuel their growth and is quite a bit more expensive. CT involves radiation. MRI can show a herniated disc causing sciatica or other problems.

Once a lung nodule is seen, follow-up to demonstrate stability is good. Widespread areas of concern are more of an issue but, as Artista says, lots of people go for years doing well.

Jillts, do let us know what your results are.

kbutler

Lindy123,Arista928 hoping for good results. jillts, never give up hope easier said than done I know ! I am going for bone scan this Friday. X-ray of thigh showed some thickening at the knee which they think is arthritis but every ache I have now my mind goes to the worst.