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A bone scan is an imaging test that looks inside bones to find damage caused by a number of conditions, including cancer. It can also help monitor how well cancer treatment is working.
A bone scan uses a very small amount of a radioactive substance called a tracer (also called a radiotracer or radiopharmaceutical) to help detect abnormal areas of bone. Because the tracer contains a small amount of radioactive substance, a bone scan is referred to as nuclear medicine.
Understandably, the words nuclear medicine can be a cause of concern for parents because exposure to a radioactive substance has potential health risks. Nuclear medicine specialists use the ALARA principle (As Low As Reasonably Achievable) to carefully select the amount of radiotracer that will provide an accurate test with the least amount of radiation exposure to the patient. The dosage is determined by the patient’s body weight, the reason for the study, and the body part being imaged. Nuclear medicine procedures have been performed for more than 50 years on adults and for more than 40 years on infants and children of all ages without any known adverse effects.
The test is performed by a certified nuclear medicine technologist and has 3 parts:
The gamma cameras, with the help of a computer, will create images called scintigrams. Areas that appear lighter or darker could indicate cancer.
Because nuclear medicine procedures can image the functions of the body at the cellular level, they can identify disease in its earliest stages as well as a patient’s immediate response to therapy. A bone scan can often find abnormalities much earlier than a regular X-ray exam.
Usually the entire body is scanned during this procedure. If results show bone damage that may be caused by cancer, more tests may be needed. These tests may include computed tomography (CT) scan, a positron emission tomography (PET) scan, magnetic resonance imaging (MRI), or a biopsy.
A nuclear medicine physician will interpret the scan results and will share them with the doctor who ordered the scan. The patient’s primary oncologist will share the results with the family.
Usually, patients do not need special preparations before a bone scan. They can eat and drink normally before the appointment.
First, a tracer will be injected into the patient’s body through an IV in the arm. The injection may sting a little bit, but the patient will not feel the tracer move through the body. It takes a few hours for the bones to absorb the tracer.
There will be a 2-4 hour delay between the injection and the scan, and the patient can leave the area and resume normal activities. The technologist will give an exact time to return for the scan. The patient may be asked to drink water during the waiting period to encourage urination. By urinating frequently, the body will remove radioactive material that has not collected in the bones.
After the waiting period, the patient will:
During the procedure:
Afterward, patients can return to normal activities. They should not feel any side effects. The medical team may ask patients to drink several glasses of water during the next 24-48 hours to flush out any remaining tracer. Usually, it is gone after 2 days.
Parents should contact the doctor immediately if they notice pain, redness, or swelling around the injection site on the patient’s arm because it could indicate an allergic reaction.
Even though the amount of radioactivity is very low, it is recommended that families take these precautions after the scan:
The nuclear medicine physician will interpret the results of the scan and will provide a report to the doctor who ordered the bone scan. This doctor will then discuss the results with the family.
Before having a bone scan, consider asking the following questions:
Reviewed: June 2018