1.What is whole body bone imaging? Bone imaging is one of the most commonly used imaging examinations in nuclear medicine, with a history of more than 30 years, accounting for one-third of the workload of imaging nuclear medicine in general hospitals at home and abroad. It is a technique of injecting osteophilic radioactive drugs into the body through a vein, and then imaging the whole body through special instruments and equipment. It can show the morphology of whole body bones more clearly, and it can reflect the blood supply and metabolism of bones, so it has important value for the diagnosis of various bone diseases and the observation of treatment effect. 2.What problems can whole body bone imaging help us solve? For patients with malignant tumors, it can detect bone metastases at an early stage, as well as the staging of some malignant tumors such as prostate cancer, breast cancer and lung cancer before treatment and follow-up after treatment; for the diagnosis of unexplained bone pain (excluding bone tumors); in addition, for subtle fractures that are difficult to detect by X-ray, such as fractures of ribs, finger bones and toes; bone imaging can also observe the survival of transplanted bone and the follow-up after artificial joint replacement, etc. The follow-up of artificial joint replacement, etc. 3.What preparation does the patient need to do before the whole body bone imaging? After the injection of the imaging agent, the patient needs to drink more water, usually about 500-1000ml of water within two hours after the injection, urination should prevent urine contamination of clothing and body, if found contaminated should promptly replace the contaminated clothes and contaminated skin local cleaning before doing the examination, and drain the urine before the examination, while removing metal objects on the body such as necklaces, keys, coins to prevent the examination results. If the patient has used barium during the recent radiology examination, it should be drained before the examination. 4.What are the advantages and disadvantages of whole-body bone imaging compared with X-ray bone films? The main advantage is that it has a high sensitivity in the detection of bone disease and can show the presence of lesions earlier than the appearance of abnormalities on X-ray. In most cases, bone imaging can detect bone metastases at an early stage, usually 3-6 months or even earlier than X-ray bone films; because a single imaging can understand the whole body skeleton, it can detect lesions outside the scope of X-ray examination, in addition, in some hidden or subtle fractures such as crack fractures of the ribs and fractures of the navicular bone of the wrist, which cannot be detected initially by X-ray and can only be detected during follow-up examinations In contrast, bone imaging is able to make a timely diagnosis. The main disadvantage is that the specificity is not high, that is to say, almost all bone diseases will show abnormal distribution of radioactivity on bone imaging, so it is difficult to make a definite diagnosis of bone disease based only on isolated localized areas of increased (or decreased) radioactivity on bone imaging. 5.Do all patients with malignant tumors need to undergo whole-body bone imaging before surgery? For most patients diagnosed with extraosseous malignant tumors, especially some tumors that metastasize to bone most often, such as breast cancer, lung cancer, gastric cancer, thyroid cancer, prostate cancer, rectal cancer, etc., regardless of whether they have bone pain symptoms or not, preoperative bone imaging should be performed to understand whether there are bone metastases in order to decide the treatment plan. 6.Is it necessary to do whole body bone imaging after treatment for malignant tumor patients without bone pain symptoms? For the above-mentioned malignant tumor patients with bone metastasis, once bone pain occurs, everyone can think of doing bone imaging as soon as possible to exclude bone metastasis. However, is it necessary to do bone imaging for patients without bone pain? The answer is that it is still necessary. Because about 19%-34% of patients have bone metastasis without bone pain. Therefore, in the first few years of the primary tumor, do not wait until the bone pain appears before you think of having bone imaging. 7.Is the abnormality of bone imaging in tumor patients always due to bone metastasis? Because of the high sensitivity and low specificity of bone imaging in detecting osteogenic lesions, some benign skeletal diseases may also show abnormal bone imaging. It is common in fractures caused by trauma; various inflammatory diseases such as osteomyelitis and bone abscess; benign bone tumors such as osteoid osteoma, bone cyst, osteochondroma; some arthritis may also show abnormal performance, such as degenerative osteoarthritis and rheumatoid arthritis. In addition, some soft tissues outside the bone can also take up bone imaging agents. In conclusion, when the bone imaging of tumor patients appears abnormal, don’t be too nervous, but combine with medical history and related imaging data to make a correct judgment.