Bone scanning in the evaluation of patients with lung cancer

Sixty patients suspected of having lung cancer were evaluated for bone metastasis by means of technetium 99m stannous-polyphosphate bone scanning and correlative radiographic bone survey. Diagnosis of lung cancer was histologically proved in all patients. Scans demonstrated evidence of bone metastasis in 20 patients (33.4%) and radiographs, in 10 patients (16.6%). Twenty-four patients had repeat skeletal evaluation at one to eleven months after the first study. Of these patients, 7 initially demonstrating both negative scans and radiographs showed abnormal scans within five months. Bone scans correlated with radiographs in 53.3% and with accompanying bone pain in 33.3% of patients. False negative and false equivocal results were noted in 4 patients. This study suggests that bone scanning with 99mTc stannous-polyphosphate detected early bone metastasis in patients with lung cancer before these lesions became evident clinically or radiographically. Bone scanning is of value during the initial evaluation to determine operability in patients with lung cancer.