Johansson JE, Beckman KW, Lindell D, Lingårdh, Rydman H, Vikterlöf KJ.
Scand J Urol Nephrol Suppl. 1980;55:31-6
Bone scanning with 99mTc-EHDP or 99mTc-MDP was compared with skeletal X-ray survey, determination of acid phosphatase levels and clinical symptoms in a consecutive series of 176 patients with prostatic carcinoma. Skeletal metastases were present in 24%. In these metastatic cases 27% had negative radiographics at the time of initial diagnosis, 29% had normal serum acid phosphatase values and 74% had symptoms other than skeletal, which dominated the clinical picture. When bone scanning was negative for metastases such lesions were never detected in the radiographs. Hence, bone scanning was sufficient for the initial diagnosis of skeletal metastases in 55% of cases. When scans were judged as equivocal or positive an X-ray survey should be done. The variations in count density in metastatic disease were followed by visual assessment of serial bone scans. A densitometric method for quantification of the variations was developed as an aid in the evaluation. Serial bone scanning using a quantitative method appears to offer a readily available objective index of early therapeutic response for use in general clinical practice as well as in controlled therapeutic trails.