A bone scan is a test that can help doctors diagnose problems with your bones. It is a useful tool for finding cancer that has started in or spread to the bone. It can also help your doctor check how well treatment is working for cancer in the bone.
How does a bone scan work?
A bone scan is a nuclear medicine test. This means that the procedure uses a very small amount of a radioactive substance, called a tracer. The tracer is injected into a vein. The tracer is absorbed in different amounts and those areas are highlighted on the scan. When cells and tissues are changing, they absorb more of the tracer. This may indicate the presence of cancer.
If the result shows change or damage to your bones, you may need more tests. These tests may include other types of bone scans. A computed tomography (CT) scan and a positron-emission tomography (PET) scan can be done following a bone scan. Further testing may also include a magnetic resonance imaging (MRI), or a biopsy.
Who does a bone scan?
A specially trained and certified nuclear medicine technologist performs the test. A nuclear medicine physician is a medical doctor who uses tracers to diagnose and treat disease. A radiologist or a nuclear medicine physician oversees the technologist. A radiologist is a medical doctor who uses imaging tests to diagnose disease. One of these doctors will read your scan and decide what it means.
You can have a bone scan done at:
A hospital's radiology or nuclear medicine department
An outpatient imaging center
Getting ready for a bone scan
When you schedule your bone scan, the hospital or imaging center staff will tell you how to prepare. Usually, you do not need much special preparation before a bone scan, but it's important to confirm this with the place giving you the test. If anything is unclear in the instructions, talk with your health care team. Here are some things that you can expect:
What to eat. You can typically eat and drink normally before your appointment.
Your usual medications. Tell your health care team about all medications you take, including over the counter (OTC) drugs and supplements. Medicines that contain barium or bismuth can affect the test results. Your doctor may ask you not to take them before your scan.
Personal medical history. Tell the staff if you have any drug allergies or medical conditions. Women should tell their health care team if they are breastfeeding or may be pregnant.
What to wear. Before the test, you will need to remove metal objects, such as jewelry. You may also need to change into a hospital gown.
Insurance, costs, and consent. If you are concerned about the costs of your bone scan, contact your insurance provider before your scan. Ask if the test is covered and how much, if any, you will have to pay. The hospital or center staff will ask you to sign a consent form when you arrive for your scan. This form states that you understand the test’s risks and benefits. The form also states that you agree to have the test. If you have concerns, talk with your doctor before you sign.
During the bone scan
First, the technologist injects the tracer into your body through a vein in your arm. The injection may sting a little bit. But you will not feel the tracer move through your body. It takes 1 to 4 hours for your bones to absorb the tracer.
While you wait, you will drink several glasses of water. By urinating frequently, you will remove radioactive material that has not collected in your bones. The amount of radioactivity in your body is safe for others to be nearby. It is less than the amount from a normal x-ray.
Next, you will lie on your back on an exam table. The technologist will place a large scanning camera above your body. You will need to remain still to prevent blurry pictures.
During the scan, the camera moves slowly around your body. It takes pictures of the tracer in your bones. The technologist may ask you to change positions during the scan. This helps to get pictures from different angles.
A whole-body bone scan takes about 1 hour to finish. The scan is not painful. You may feel discomfort from staying in the same position for a long time.
After the bone scan
You can do normal activities after the scan. This includes driving. You should not feel any side effects from the tracer or the test itself.
Your doctor may ask you to drink lots of water for the next 1 to 2 days. This flushes out any tracer left in your body. Typically, all of the radioactive material washes away after 2 days.
Call your doctor right away if you have pain, redness, or swelling around the injection site on your arm.
Questions to ask your health care team
Consider asking these questions before having a bone scan:
Who will do the bone scan?
Is the radiologist or nuclear medicine physician board-certified?
Is the facility accredited by the American College of Radiology to do bone scans?
What will happen during the bone scan?
How long will the scan take? How long will I need to be at the hospital/center?
What are the risks and benefits of having a bone scan?
What will the results of this bone scan tell you?
When and how will I learn the results?
Who will explain the results to me?
What other tests will I need if the bone scan finds signs of cancer?
ASCO Answers Fact Sheet: When Cancer Spreads to the Bone (PDF)
RadiologyInfo.org: General Nuclear Medicine