what is best test to diagnose bone mets

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Kathie100
Kathie100 Member Posts: 108
edited June 2014 in Not Diagnosed With a Recurrence or Metastases but Concerned

Which test is the best at identifying Mets to the bone. I heard bone scan won't pick up lytic bone Mets, pets can has a lot of false positive and I'm not sure about a CT scan or MRI. I know before my lumpectomy I had a MRI and they said the biopsy must of gotten the tumor because it didn't show up but when I got to surgery it was almost 1cm which seems pretty big to of missed. Also how big do Mets have to be to begin causing problems. I'm having severe back and hip pain since October and its getting worse. My bone scan clear didn't even show arthritis. I just started arimidex last week so its not that. Any ideas?  I have appt with orthopedic dr Friday. What should I ask for???

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  • pajim
    pajim Member Posts: 2,785
    edited January 2014

    Hi Kathie, as you say, different tests show different things.  PET/CT is the one generally used to detect.  It shows cells or groups of cells which take up radioactive sugar better than other cells.  The tumors do have to be big enough to show up --micrometastases won't show.

    CTs have to be interpreted -- cancer lesions and healing lesions show up the same and the radiologist has to guess.

    I don't know much about bone scans -- I've never had one.  MRIs won't do this particular job.

    The absolute gold standard for proving cancer IS there is a biopsy. 

    As I understand it,most bone mets are diagnosed when someone breaks something, or when there are sufficient symptoms that an MD does an imaging test.  As for how big they have to be, I have no idea. It's different for every person.

    Is it possible you have a disc problem?  Some other kind of neurologic issue?  This doesn't have to be cancer at all.

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  • sandilee
    sandilee Member Posts: 1,843
    edited January 2014

    My onc prefers MRI for bone mets.  They show the spine in great detail, including the marrow. I'm monitored for my spine with MRI and CT scan for soft tissue.   I would ask your orthopedist for an MRI.  They may decide to do it on their own with your history of BC.  The good thing about an MRI is that with the detail they can tell if your spinal cord is compromised, and see exactly what's going on in each vertebra. 

        I found my mets through an orthopedist. First they just did an X-ray. When that showed nothing wrong, they did the MRI.  I got a call that afternoon from the orthopedist, and he called my onc afterward. I was in radiation that night. 

         If your bone scan was clear recently, you likely have some other problem like disc disease that isn't cancer but is stii painful.  An MRI would help diagnose that.  Good luck- and good for you for following up. Don't let it go too long.  (Hugs)

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