Reliability of symptoms to determine use of bone scans to identify bone metastases in lung cancer: prospective study.

Based on the hypotheses that most skeletal metastases in lung cancer are clinically symptomatic, that the incidence of bony metastases in early stages is low, and that bone scintigraphy has a sensitivity of nearly 100%, leading professional societies recommend diagnostic skeletal imaging depending on clinical symptoms. 2 No study has assessed the significance of skeletal symptoms as a criterion for skeletal imaging in patients with lung cancer since 1991. But in the intervening period gamma camera technology has been considerably refined and more sensitive methods such as magnetic resonance imaging have become available for skeletal imaging. We redetermine the role of symptoms and serum concentrations in detecting bony metastases in lung cancer and reassess the accuracy of bone scans for screening.