Bone Scanning in Clinical Practice

1. Front Matter

   Pages i-xviii

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2. The Bone Scan—Historical Aspects

   • I. Fogelman

   Pages 1-6

3. 99mTc Diphosphonate Uptake Mechanism on Bone

   • M. D. Francis, I. Fogelman

   Pages 7-17

4. The Normal Bone Scan

   • M. V. Merrick

   Pages 19-29

5. 99mTc Diphosphonate Bone-scanning Agents

   • I. Fogelman

   Pages 31-40

6. Bone Scanning in Metastatic Disease

   • J. H. McKillop

   Pages 41-60

7. The Bone Scan in Primary Bone Tumours and Marrow Disorders

   • J. H. McKillop

   Pages 61-72

8. The Bone Scan in Metabolic Bone Disease

   • I. Fogelman

   Pages 73-87

9. The Bone Scan in Paget’s Disease

   • I. Fogelman

   Pages 89-104

10. The Role of Bone Scanning, Gallium and Indium Imaging in Infection

    • K. Mido, D. A. Navarro, G. M. Segall, I. R. McDougall

    Pages 105-120

11. The Bone Scan in Traumatic and Sports Injuries

    • P. Matin

    Pages 121-132

12. The Bone Scan in Arthritis

    • L. Rosenthall

    Pages 133-150

13. The Bone Scan in Avascular Necrosis

    • L. Rosenthall

    Pages 151-174

14. Orthopaedic Applications of Single Photon Emission Computed Tomographic Bone Scanning

    • B. D. Collier

    Pages 175-187

15. The Bone Scan in Paediatrics

    • I. Gordon, A. M. Peters

    Pages 189-209

16. Soft Tissue Uptake of Bone Agents

    • H. W. Gray

    Pages 211-235

17. Quantitative 99mTc Diphosphonate Uptake Measurements

    • M. L. Smith

    Pages 237-248

18. Measurements of Bone Mineral by Photon Absorptiometry

    • H. W. Wahner

    Pages 249-256

19. Back Matter

    Pages 257-260

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The most frequently requested investigation in any nuclear medicine department remains the technetium-99m (99mTc)-labelled diphosphonate bone scan. Despite rapid advances in all imaging modalities. there has been no serious challenge to the role of bone scanning in the evaluation of the skeleton. The main reason for this is the exquisite sensitivity of the bone scan for lesion detection. combined with clear visualisation of the whole skeleton. In recent years several new diphosphonate agents have become available with claims for superior imaging of the skeleton. Essentially. they all have higher affinity for bone. thus allowing the normal skeleton to be visualised all the more clearly. However. as will be dis­ cussed. this may occur at some cost to the principal role of bone scanning. lesion detection. The major strength of nuclear medicine is its ability to provide functional and physiological information. With bone scanning this leads to high sensitivity for focal disease if there has been any disturbance of skeletal metabolism. However. in many other clinical situations. and particularly in metabolic bone disease. more generalised alteration in skeletal turnover may occur. and quantitation of diphosphonate uptake by the skeleton can provide valuable clinical information.

• bone
• imaging
• nuclear medicine

• Department of Nuclear Medicine, Guy’s Hospital, London, UK

  Ignac Fogelman

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