[Conventional imaging and computerized tomography in diagnosis of skeletal metastases]

The most effective whole-body screening test for bone metastases is the radionuclide bone scan. Conventional radiography is the best modality for characterizing metastatic lesions. Furthermore, conventional radiographs are useful for depicting impending or early pathologic fractures. The radiographic sensitivity depends on the extent, location and type of bone metastases. Therefore, normal radiographs in patients with either a positive bone scan or persistent, unexplained pain must be suspect. In these cases CT may establish the diagnosis. However, metastatic lesions in the marrow space without architectural changes in the surrounding bone can be detected only by MRI. The use of CT is also helpful in determining the local extent of bone destruction and extension into the surrounding soft tissues when planning surgery or radiotherapy.