The Journal of Bone and Joint Surgery, Vol 66, Issue 9 1400-1407, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
The comparative value of bone scintigraphy and computed tomography in determining bone involvement by soft-tissue sarcomas
TM Hudson, M Schakel, DS Springfield, SS Spanier and WF Enneking
In seventeen patients with a soft-tissue sarcoma, bone scintigrams were
found to be more useful than computed tomograms for evaluating bone
involvement. The scintigrams had higher predictive value and higher
sensitivity, as there were no false-negative or false-positive scintigrams,
while there were three false-positive computed tomograms. Accurate
scintigraphy requires the use of high-resolution static gamma-camera images
that show the tangential relationship between tumor and bone. The images
that are usually made in surveying the skeleton for metastatic
disease--routine whole-body bone scans, or even gamma-camera images that
provide only anterior and posterior views--are inadequate. They did not
demonstrate the true relationship of the tumor to bone in the patients in
this study when activity within the tumor itself was superimposed over
bone. In such patients, properly selected oblique views sometimes showed
that the tumor was clearly separate from normal bone activity.
Determination of the relationship of the soft-tissue tumor to bone is an
important part of the accurate anatomical staging that is required to
select appropriate surgical management.
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