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Should I use Whole body bone scan or MRI to detect bone irregularities or bone Cancer?

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Hi everyone,

Should I use whole body bone scan or MRI of both Lumber Spine and pelvis to detect bone irregularities or bone cancer? Please comment on pros and cons. Thank you.

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  • exbrnxgrl
    exbrnxgrl Member Posts: 4,749
    edited May 2023
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    Why are you thinking you have bone cancer? If you have been dx’ed with breast cancer and you are worried about it spreading then please know that wherever it might go, it is still breast cancer and is treated as such. Bone, liver, brain cancer, etc. are not treated the same way as breast cancer (yes, there may be some treatment overlaps). Breast cancer is breast cancer regardless of where it spreads and will be treated as breast cancer.

    No imaging modality is perfect. By whole body scan, do you mean PET or CT? What do your own doctors recommend? I have bone metastasis and my facility generally uses PET scans however I will be having a CT with contrast on Friday and a nuclear bone scan on Monday. Each imaging modality has pros and cons and none are perfect. Take care

  • new2bc
    new2bc Member Posts: 252
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    Hi exbrnxgrl,

    What doctor requested was an MRI of Lumber spine and Pelvis. But I just found out that insurance has denied it and I need to do the nuclear whole body scan instead. This looks like the same one you will do on Monday. Any info on this test you can provide? Thanks

  • cookie54
    cookie54 Member Posts: 662
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    @new2bc Hi, A Whole Body Bone Scan they will inject a radioisotope and you will return 2 hours later for imaging. This will cover a larger area than MR and is able to show increased uptake of the isotope in areas of concern. It can alerts to bone mets, arthritis, fractures old and new.

    Mri of Lsp and pelvis will obviously just include those areas and can also show abnormalities of bone and many other things. Can show the same things mentioned above plus disc herniations, spinal cord issues etc.

    Typically if ruling out bone mets the study of choice to start is a Whole Body Bone scan. If a questionable area is seen then they can order the appropriate body part to be scanned via, MR,CT or PET.

    Hope this info helps, best wishes.

  • exbrnxgrl
    exbrnxgrl Member Posts: 4,749
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    Are you referring to a PET, CT or the nuclear bone scan? There are different procedures for all of them. I think “nuclear whole body scan” is not a very specific term and actually sounds more like a PET but please clarify that with your doctor.

  • cookie54
    cookie54 Member Posts: 662
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    This may help to clarify:

    Bone scans, positron emission tomography (PET), and computed tomography (CT) all continue to be employed alone or in combination for the detection of breast cancers suspected to have spread. In some cases, physicians use all three imaging techniques. Each has its own strengths. For example, bone scans detect bony regions in the process of growth or repair, which can be a sign of metastatic disease. PET, on the other hand, assesses irregularities of biochemical activity in the body, such as cells that metabolize glucose unusually fast. Such behavior is a trademark of a cancer cell. Meanwhile, CT creates anatomical images that can help physicians isolate and analyze the size and shape of tumors

  • new2bc
    new2bc Member Posts: 252
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    Thank you everyone for answering my question.

  • AJ
    AJ Member Posts: 185
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    when I was diagnosed they had me do a nuclear bone scan just to check my bones.

  • HoldingOn52
    HoldingOn52 Member Posts: 10
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    I had unexplained increase in bone density on DEXA scan compared to prior scan (though I'm not on bisphosphonates), so my MO ordered a bone scan. The bone scan showed two areas of uptake in the lumbar spine (the same location with the increased density) but the radiology report is recommending either a CT or MRI to help determine if this is degenerative changes or bone mets.

    If my MO gives me a choice, which of these (CT or MRI) would be the most definitive in establishing whether the bone scan uptake on the left side of L3 and on the right side of L5 is degenerative disease (I'm 71) or bone mets?

  • laughinggull
    laughinggull Member Posts: 511
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    I suspect your insurance and your MO will have opinions on which scan type should come next, and will not leave the decision to you. That is my experience. I wish you best of luck in any case.

  • sunnidays
    sunnidays Member Posts: 153
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    The standard would be a nuclear bone scan and a CT scan and the results are read together, then a bone biopsy before a definitive diagnosis is made, if there are still uncertainties then an MRI. That is what my oncologist told me when I was diagnosed.

  • HoldingOn52
    HoldingOn52 Member Posts: 10
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    Thank you both!