Clinical use of radionuclide bone imaging in a university medical center

To assess the diagnostic utility of radionuclide bone imaging, we reviewed all examinations performed during a two-year period in a university medical center. The indication(s) for each bone image and its interpretation were compared by reviewing requisition forms and medical records. Thirty-nine percent of 988 studies demonstrated relevant abnormalities. Yields of pertinent positive findings were greatest in patients with cancers of the breast (40%) and prostate (38%) and lowest in women with uterine cancer (15%), patients with previously normal bone images, and individuals with suspected but unconfirmed malignancy. Incidental findings, unrelated to the indication for imaging, occurred frequently (up to 41% of cases). We did not find a sizable number of negative studies that could readily be labeled as unnecessary, suggesting that bone imaging to generally a useful procedure as applied by physicians in this setting.