There is little information in the literature concerning the role of bone scanning in benign
bone neoplasms except for sporadic reports. Since the advent of 99mTc-polyphosphate, bone imaging has proven feasible and useful in locating the cause of bone
pain, such as in
osteoid osteomas, which are not always radiologically apparent, and in evaluating whether or not a radiologic lesion is indeed benign and solitary. Blood-pool images are particularly important in neoplastic disease, since the absence of
hyperemia in the immediate postinjection period favors the diagnosis of a
benign neoplasm, as does low-grade uptake on the delayed study. The scan, including pinhole magnification images, is especially valuable in diagnosing lesions in the spine and pelvis, which are poorly seen radiologically. We have studied various types of benign bone
tumors, including simple and
aneurysmal bone cysts, fibrous cortical defects, and nonossifying
fibromas, all of which had minimal or no increased uptake of the
radiopharmaceutical, unless traumatized. Although
osteochondromas and
enchondromas showed varied accumulation of activity, the scan was useful in differentiating these from sarcomatous lesions. All
osteoid osteomas demonstrated marked activity, and could be accurately located preoperatively, as could the extent of fibrous dysplasia. The bone scan in the reticuloses also showed abnormal accumulation of activity, and aided in arriving at the prognosis and treatment of histiocytic bone lesions.