A unified radiological approach to the detection of skeletal metastases

Radiographic bone surveys and radionuclide images, the principal methods of detection of skeletal metastases, have traditionally been treated as separate entities. Since their interpretation is reltaed, we attempted to determine the practicability of a unified radiological approach which employs both methods. All consultation requests for "skeletal surveys" or bone scans were reviewed, and an appropriate examination was "tailored" for each patient. During the inital four-month period, 141 patients were examined. Comparison of the final "tailored" examination with the original consultation request indicated that, without radiological guidance, excessive (18%), and inappropriate or inadequate (27%) examinations were ordered in many cases. The unified approach has proven to be feasible and desirable, resulting in a significant reduction of inappropriate examinations.