PET scan vs. Bone Scan

mom2daughters · May 2009

Which is better to detect a bone Met. I have had a PET scan but never a bone scan.

Have a terrible pain in my knee/leg. Had this pain for quite sometime, about 6 months or so. While at the GYN for my check-up showed her and she found several lumps behind the knee. Mentioned it to my Onc. who ordered a dopler to rule out DVT or bakers cyst. Dopler came back neg, but pain is still there and intense, wakes me up and very hard to sleep

I have appt. this week with onc. and want to get to the bottom of this. Thanks for any help.

MREanes · May 2009

I don't know which is better at detecting bone mets, but I would guess that a bone scan is less expensive.

I am no expert, but I think that it would be uncommon for bone mets to make their first apperance in your knee. I think that they are more common in ribs, spine, pelvis and femur.

Hopefully, your pain is coming from another problem. However, you should definitely get it checked out to be sure.

Take care,

Mike

marejo · May 2009

A bone scan would be the best way to detect a bone met.

Hope you are soon feeling better.

MJ

Skyrat · May 2009

I just have to reply to this post with my own experience. I have bone mets - all the L vertebrae, a few T vertebrae and the C1 vertebrae, along with the pelvic bone and some ribs. The bone mets were detected with the PET/CT Scan. The bone scan did not show anything other than a couple of areas of degenerative disc disease. I asked my onc why one showed all these mets, and the other didn't. I apparently have the type of bone mets that doesn't show up on a bone scan - I think it's the blastio lesions. MRI and PET/CT pick up the bone mets, bone scan does not.

ednagbbw · June 2009

Skyrat:

So if a person were to have lytic lesions, a Bone Scan would be best? I've had bone scans show something and PET/CT scans show nothing. I also have lumps where the hot spots were located on the Bone Scans. This would be lytic lesions as opposed to blastic right?

Edna

Anonymous · June 2009

I had/have a very rare form of BC, am tri/neg, and carry a rare form of the cancer gene (0nly in 12 families). My Onc told me if my BC spreads it would be to the bone or liver. He has ordered CT/PETs every 6 months. My last scans, in May, showed "activity" in the spine and hip. My docotrs are concerned. I am not sure if there was also a bone scan as I think they just go along with the combo of CT and PET but may be incorrect. I do know the PET glows if cancer is present and I do not believe that occurs with just the bone scan.

Skyrat · June 2009

Edna - I am not sure. I do know the onc told me that if my lesions were lytic, they would have shown up on the Bone Scan. I'm sure that he told me that both types showed up on the PET/CT Scan. I just know that I was horrified to think of all the women who only get bone scans because the oncs don't like the possibility of false positives on PET/CT Scans. My onc will take the scan, and then another one 3 months later and compare. So far, knock on wood, the insurance company has been very compliable.

GoldenEyes · February 2010

Silly Question.. Did you ladies have confirmed METS.. without a biopsy?

TriciaK · February 2010

A biopsy would be definatly a must to determine her2 and hormone status as sometimes this can change with mets.

Tricia xx

GoldenEyes · February 2010

Tricia

I consulted with my Onc.. My Rad. Onc .. My Spine Surgeon and the Radiologist that read my Scans..They all agreed its BC Mets to Cervical Spine...They feel it is too risky to do a biopsy on my cervical spine..( I DONT WANT IT!) The wrong move.. if they slip.. could paralyze me (spelled right?) Seems where the tumors are on my cervical spine.. would be too risky for biopsy.. They are going by my past history with cancer.. (3 times in 7 1/2 yrs) my symptoms.. pain from neck down.. swelling...pins and needles down to my fingers and numbness in my hands...I have been having constant pain for MONTHS.. I see the Rad Oncologist in PA Thursday.. They want to start radiation.. soon..that wil take care of the pain I have.. and hopefully shrink the tumors...get rid of them for good..Has anyone ever had JUST rads for mets.. without chemo?.. For now.. He said do the rads.. take more scans when I am done....IF the tumors are still there.. then we will talk about chemo again

shastamom · December 2011

I am so confused about this topic. I was diagnosed in 2/2010 with Stage IV, with mets to bone and lung. After treatment with taxol & avastin, followed by arimidex and zometa I appeared to be in remission. In August of this year, after weeks of me complaining of headaches my onc ordered an MRI of my head, which showed nothing wrong. A few weeks later, I saw a "fill-in" onc, who ordered a bone-scan, which showed bone mets as extensive as when I started. I don't understand how the MRI could miss what the bone scan showed. Yesterday, I had a CT scan - just of the torso. The report cites "extensive sclerosis" in lumbar spine, pelvis and femor "consistent with blastic metastases" but says "this did not change from the 6/15/11 study." In June, I was being told I was still in remission!

So of course I started researching on line - found a textbook on bone mets. According to it, Nuclear bone scans are better at picking up blastic than lytic metastases, and that purely lytic disease can produce false negatives. The "sclerotic lesions" are areas of bone formation, and may be due to healing process as well as disease process.

I have a ridge on my forehead that is periodically tender, and I feel like crap all the time! But I still don't know whether I have progression of the bone mets, or I'm just healing. But I have definitely lost confidence in "clean scans" as having any real meaning.

PET scan vs. Bone Scan

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