A bone scan should not be confused with bone densitometry (DEXA) scan. The former is a nuclear medicine imaging procedure that can help detect conditions such as bone tumor, bone cancer, infections, fractures, arthritis, bone trauma, osteoporosis, etc. On the other hand, a DEXA (Dual X-ray Absorptiometry) scan measures the density of bones.
A bone scan, which is also called bone scintigraphy, is one of the common types of nuclear medicine imaging procedure. Basically, nuclear medicine is a branch of imaging where radiopharmaceuticals are used for examining the function and structure of tissues and organs. Bone scintigraphy helps check the structure and function of bones. This procedure involves the administration of a small amount of radiopharmaceutical into a vein. This radioactive substance is also referred to as a radioactive tracer. Tc-99m MDP (where Tc stands for Technetium and MDP stands for methylene diphosphonate) is one of the commonly used radioactive tracers. The standard dose for adults is around 740 Mbq.
The radioactive component of the medication becomes radioactive as it breaks down. This substance causes the body part that is being studied to become radioactive for a short duration. When the ionizing radiation is emitted from the body, it is detected and measured using a gamma camera. This imaging procedure can help detect tumors, infection, or abnormalities in bones. It can also determine the extent of spread of cancer. Also, this scan can help the doctors ascertain if cancer treatment is working or not.
How Is a Bone Scan Performed
The procedure is performed under the supervision of a radiologist who has completed specific training in nuclear medicine.
➠ In the first phase, which is called blood flow phase, images are taken with the gamma camera immediately after the administration of radioactive tracer. This allows the radiologist to analyze the blood flow to the area being scanned.
➠ In the second phase, which is also called blood pool phase, the images are taken about 5 minutes after the administration of the injection. These images can help reveal any soft tissue involvement.
➠ The third phase is also called delayed phase. The radioactive tracer usually takes 2-3 hours to circulate in the blood and get absorbed in the bone. Thus, the patient is asked to come back after 2-4 hours. The person undergoing the scan is asked to empty the bladder, and remove jewelry or metallic items that he/she might be wearing. Thereafter, he/she will have to lie down on the imaging table. During this time, pictures are taken by the gamma camera. A whole body scan can take about 30-45 minutes.
While the task of measuring and administering the radioactive tracer, as well as using the equipment (gamma camera/computer) is performed by the nuclear medicine technologist, the images are interpreted by the radiologist. A bone problem is suspected when hot spots are observed. Basically, hot spots are areas of the bones that absorb more than normal amount of radioactive tracer.
Factors Affecting the Cost of a Bone Scan
A bone scan normally costs anywhere between USD 150 and USD 600. However, the overall cost might vary, depending on certain factors. These include:
It's likely that hospitals or clinics that are located in metropolitan areas charge more for the bone scan. A radiologist who has completed specific training in nuclear medicine supervises the procedure, whereas a certified nuclear medicine technologist administers the radioactive tracer and handles the equipment. The hospital/clinic charges, radiologist's fee, and technician's charges are likely to be higher in cities that have a higher cost of living. However, even in the metropolitan areas or big cities, one can look for non-profit hospitals that provide monetary aid to patients who are poor/uninsured. Also, certain hospitals and imaging centers with a larger patient base might perform the procedure at a lower cost.
Many health insurance companies cover the cost of bone scintigraphy. However, those who are insured must contact their health insurance company to find out whether the full cost or a part of the cost of the bone scan is covered under their plan. You might have to pay nearly 10% to 40% less than the actual cost, depending on the type of health insurance.
The overall cost is bound to increase, if an additional imaging procedure called single-photon emission computerized tomography (SPECT) is recommended. SPECT is suggested in cases where the two-dimensional images don't suffice. For instance, imaging procedures such as the SPECT or SPECT-CT (a combination of SPECT and CT) might be recommended by the doctor when he/she suspects infections, fracture, or cancer deep within the bone. SPECT or SPECT-CT provide the three-dimensional images of the part of the body being scanned, thereby providing valuable diagnostic information, which two-dimensional (planar) images cannot provide.
Condition of the Patient
If the patient is affected by a serious medical condition, additional care needs to be taken. Under such circumstances, the patient's condition has to be monitored while the scan is in progress. Though minimal risks are involved in bone scintigraphy, immediate medical assistance would be required, if the patient develops an allergic reaction. This might contribute to the overall cost.
On a concluding note, a bone scan is a useful imaging technique that enables the early detection of bone-related conditions. It must be noted that this procedure is not recommended for pregnant women and nursing mothers. So, consult your healthcare provider about the risks associated with this imaging procedure. Also, clarify any doubts related to its cost with the hospital/clinic and your insurance company. Those who are uninsured can find out if the hospital offers any financial assistance program.Disclaimer: This article is for informative purposes only. The aforementioned cost is subject to change, and might differ from region to region.