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Bone scan vs PSMA PET scan

Posted by johndavis60 @johndavis60, 3 days ago

I had a PSMA PET scan in July 31, and a bone scan today ( sept 4). Don’t ask me why my MO ordered this bone scan, maybe she wanted some baseline imaging to compare with if I do another bone scan in the future? Who knows?
Anyway, the bone scan today picked up a faint spot on the left side of my scull, but the PSMA PET scan shows nothing in the same area. Should I worry? I meet with my MO on Monday.

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surftohealth88 | @surftohealth88 | 3 days ago

As far as I know, bone scan can detect many other things beside cancer - infection, fracture, arthritis etc. I also think that if it was something of importance that your doctor would already call you or sent message to inform you about it. However- I can totally see how unnerving that might be : (((, and on top of everything you have to wait till Monday. *ughhh Can you call them tomorrow and ask about that spot ?

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johndavis60 | @johndavis60 | 3 days ago
In reply to @surftohealth88 "As far as I know, bone scan can detect many other things beside cancer - infection,..." + (show)
Profile picture for surftohealth88 @surftohealth88

As far as I know, bone scan can detect many other things beside cancer - infection, fracture, arthritis etc. I also think that if it was something of importance that your doctor would already call you or sent message to inform you about it. However- I can totally see how unnerving that might be : (((, and on top of everything you have to wait till Monday. *ughhh Can you call them tomorrow and ask about that spot ?

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From everything I read this is probably not serious. My MO prefers to talk about these things at our appointments and since I have one on Monday, I’ll just wait until then and try to put this out of my mind.

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brianjarvis | @brianjarvis | 3 days ago

Dr. Johnson (of Mayo Clinic) talks about all this in his presentation, starting with the scans we’ve all heard about (MRI, bone, & CT scans), and then going into detail about PSMA PET: https://youtu.be/JoJomACA5UM

(He also discuss the value of MRI, bone, and CT scans in support of PSMA PET scans. This basic information might help as you meet with your MO on Monday.)

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northoftheborder | @northoftheborder | 3 days ago

They can all produce false positives (PSMA-PET most of all, I think), so using more than one type of scan can help make them more confident about separating the signal from the noise. E.g. if something shows up on all three, then there's a stronger chance it's cancer-involved than if it shows up on just one.

Here's an example with two scans. I had a metastasis on my spine in 2021, which was treated with emergency debulking surgery and then radiation. My most recent CT scan last spring showed some lucency there, but a bone scan (which would be more accurate for the spine) showed nothing. Combine that with the facts that my ALP blood test is in normal range (it would often be elevated with a new bone metastasis), that my PSA remains undetectable (< 0.01) on the ultrasensitive test, and that it's exactly where the surgeon operated and fused my spine with cement and screws 4 years ago, and both the radiologist and oncologist are highly confident that the CT lucency is just showing my bone healing, not anything cancer-related. (Still, we plan an MRI next week just to be extra, extra certain.)

That's the way it goes. No one test is decisive, but the more positives you get, the more "votes" you have that there might be cancer.

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