Abstract
From January 1975 to December 1976, 180 cancer patients were found to have abnormal accumulations in the vertebrae on their bone scintigrams. These patients were carefully surveyed through their clinical records for more than two years follow-up, x-ray pictures, and autopsy findings; and finally 115 patients were selected for this study. Abnormal accumulations were classified into two categories; significantly positive and equivocal. Among these 115 patients, significant accumulations were found in 85, and equivocal in 17. The remaining 13 showed both significant and equivocal accumulations. In 81 out of 98 (85+13) patients, the significant accumulations were due to metastases; and in 15 out of 30 (17+13) patients, the equivocal accumulations were due to metastases. However, if the cases with equivocal accumulation only are taken into consideration, the true positive cases are only 3 of the 17. The major factor for false positive was degenerative changes of the vertebrae in either group of significant or equivocal accumulations. Although it is difficult to differentiate benign changes of the vertebrae from the metastases on the bases of scintigram findings only, a cushion-like pattern in disc degeneration as well as in collapse of the vertebral body, a vague concentration with indistinct margin in spondylosis deformans, and sym-metrical accumulations in the intervertebral joints due to sclerotic changes are helpful in evaluating the bone scintigram of cancer patients, together with the site of abnormal accumulation and the age of the patient.
