The bone scan shows increased tracer uptake within the right hemipelvis in keeping with the primary tumour previously identified. It demonstrates further areas of tracer uptake. List some of the involved bones.
Increased tracer uptake in: left orbital ridge, multiple ribs, both scapula, both humeri, bilaterally within the pelvis, both femora.
What is the next best course of action?
A histological diagnosis is required to determine the best therapeutic course.
The flow and blood pool images of the pelvis show moderate increased tracer uptake involving both hip joint regions, more pronounced on the right side indicating evidence of hyperemia.
On total body skeletal images, the skull shows multiple foci of heterogeneous and diffuse tracer uptake with a focal more intense uptake involving the left orbital ridge most likely metastatic in nature. Further diffuse and heterogeneous uptake (likely metastatic deposits) in:
- multiple ribs on both sides
- both scapula
- both humeri
- right iliac bone
- both acetabulum/ischium
- left iliac crest
- both femora
Multiple vertebral bodies in the thoracolumbar region also show heterogeneous moderate tracer uptake worrisome for metastasis.