Bone Scan for Cancer

Bone scans can be used to find cancer or plan further cancer treatment. You might also hear them called skeletal scintigraphy.

What is a bone scan?

A bone scan is a type of nuclear medicine scan that uses radioactive tracers to show abnormal activity in your bones. The radiotracers (tracers) travel to the bones in your body, then a gamma camera takes pictures. These pictures pick up dark spots where cells are active.

The images it creates are called scintigrams.

Radiation exposure from a bone scan is minimal, and the radioactive material passes through your body quickly.

What does a bone scan show?

Bone scans show abnormal spots or changes in the bones. A bone scan can show the entire skeleton at once.

It can help doctors:

• Diagnose bone problems, such as fractures or infection
• Find cancer that has started in the bone or spread to the bone
• Check to see if cancer treatment is working

How does it work?

Bone scans use a radioactive material called technetium-99. It is put into a vein and travels to your bones. The scan happens after the tracer has collected in the bones, which takes a few hours.

Abnormal spots or changes in the bones take up more of the tracer material, so they appear as “hot spots.” These “hot spots” may be from cancer, but they can also be from other bone disorders that cause the same pattern.

A doctor who specializes in nuclear medicine interprets the scan and sends a report to your healthcare team. This doctor is called a radiologist.

To confirm a diagnosis, bone scans might be combined with other tests, such as MRI, PET/CT, or biopsy.

How do I get ready?

Bone scans are usually painless. Most of the time, they are done in the nuclear medicine department of a hospital or clinic.

Your healthcare team will tell you exactly what you need to do to get ready for your scan. You may be asked to:

• Avoid some prescription and over-the-counter medicines before the test.
• Tell your healthcare team if you’ve had a recent x-ray test with barium.
• Drink extra fluids to help the tracer move out of your body.
• Bring something to read or work on while you wait for the tracer to move through your body.

Tell your care team everything you take. This includes over-the-counter medicines, vitamins, and herbs. Tests that use barium, and certain medicines, can affect the test results.

What is it like having a bone scan?

A nuclear medicine technologist (tech) will do the scan.

For your safety and to get the best images, you may be asked to:

• Undress and change into a gown.
• Remove all metal objects that can interfere with the test.
• Follow other instructions given to you by the tech.

Getting the tracer

Before the scan, the tracer will be injected into a vein. It may take a few hours for it to get to your bones so images can be taken. Your tech will let you know how long this will take.

To remove extra tracer from your body, you may be asked to:

• Drink water while waiting for the tracer to collect in your bones.
• Empty your bladder before the scan starts.

Removing extra tracer provides clearer images.

During the scan

You will lie on a table with a camera placed above you. The camera will move around your body to take images of your bones. The tech may ask you to lie very still or change positions during the scan.

Lying still on the table for long periods of time may be uncomfortable. Also, the camera will get very close to your body. Let your healthcare team know if closed spaces bother you.

The tech will be in a nearby room, but they can always see, hear, and talk to you.

After the images are taken, the tech will review them to make sure they are clear and show everything. If not, you may need more images.

After the scan

You may be asked to continue drinking lots of water over the next few days to flush the tracer out of your body. You usually do not need to limit contact with other people after a bone scan, but your healthcare team will tell you if you do.

The radiologist will review the images and create a report for your cancer care team to discuss with you.

How long does a bone scan take?

The tracer used for a bone scan can take up to 4 hours to move through your body. During this time, you will be asked to wait at the hospital or clinic. You will drink a lot of water to flush out any tracer that doesn’t collect in your bones.

The scan itself takes about another hour or so.

What are the possible risks and side effects?

When the tracer is injected, you may feel cold. You might also have redness or feel discomfort or pain where the IV goes into your body. These usually go away quickly.

Allergic reactions from the tracer are very rare, but you should watch for any symptoms. Tell your healthcare team if you have problems, such as:

• Breathing problems, shortness of breath, or wheezing
• Swelling
• Rash
• Blood pressure issues

Lying on the exam table for a long time may cause discomfort if you have bone or joint pain.

The camera is very close to your body during the scan. If you have a fear of closed spaces, this might bother you. It can help to make a plan for managing this with your healthcare team before the scan.

What else should I know about a bone scan?

• If you are pregnant or breastfeeding and need a bone scan, talk to your healthcare team about the best plan for you.
• Ask if your insurance covers this test before you have it.

Learn more

• Imaging Tests for Cancer