Additive clinical value of bone scintigraphy in patients with malignant tumors with absence of localized bone pain: A report on most common sex-related cancers

  Introduction: Almost all malignant tumors have the potential to eventually produce bone metastasis. The aim of the current study was to report the distribution pattern and imaging characteristics of bone metastases detected by conventional whole body bone scintigraphy in patients with different types of malignancies and to assess their relationship with the complaint of bone pain. Methods: As a cross-sectional study, 146 consecutive patients with histologically proven cancer who were referred for the assessment of possible bone metastatic involvement were investigated by 99mTc-Methylene Diphosphonate (MDP) whole body scintigraphy. Results: A total of 146 patients (79 male and 67 female; mean age: 59.59±11.95) were enrolled, of which 71 (48.6%) patients had prostate cancer, 61 (41.8%) breast cancer, 6 (4.1%) gastric malignancy, and 8 (5.5%) miscellaneous cancers. The most frequent sites of bone metastases (vertebrae, pelvis and sternum) demonstrated more intense radiotracer uptake. Most of patients (58.5%) with bone metastasis due to breast cancer reported no localized bone pain. Also in the subgroup with prostate cancer, no significant association was noted between the site of bone metastases and location of the pain perception in most of the skeletal zones. Conclusion: Bone scintigraphy (by determining the specific pattern of bone metastases in different tumor types) may help physicians provide better care for patients who suffered from metastatic cancer. On the other hand, in view of the fact that no reliance can be placed on clinical symptoms and the patients' report of bone pain, bone scintigraphic data can be included in the follow-up evaluation of patients suspected to have bone metastasis, even in the absence of bone pain.