[The importance of bone scintigraphy in the aftercare of patients with malignancies]

The present review is concerned with the value of bone scanning in the follow-up of patients with malignant tumors. The scintigraphic sensitivity depends on the type of bone metastases. Osteoplastic metastases (e.g., from prostatic cancer) can be detected much more easily than purely osteolytic foci (e.g., of multiple myeloma). One controversial point is the role of bone scans in the follow-up of patients with breast carcinoma. This particular malignancy is used as an example to point out irrationalities in the recommendations on the selection of imaging modalities in routine follow-up. Such recommendations are based on the present knowledge of the tumor growth kinetics, which is still inadequate. In view of this, follow-up strategies should not be based solely on statistical and epidemiological considerations and cost-benefit ratios.