Is the skull view necessary in routine gamma camera bone scanning?

Bone scans were reviewed in 478 patients, 237 with carcinoma of the breast, 47 with carcinoma of the lung, 43 with carcinoma of the prostate, 56 with other malignancies and 95 in whom scans were performed for basic screening purposes. In only 11 of the scans reviewed were abnormalities of the skull alone observed and in only one of the 11 scans was the finding of an abnormality thought to be clinically useful. This study suggests that in patients with known malignant disease, the skull view adds little useful information. However, when performing bone scans for screening purposes, the skull view may well give helpful information.