-  Bone scan must show increased tracer uptake in pain areas.

-  Management of eventual spinal cord compression or fracture in extremities is adviced before radionuclide therapy.

-  Make sure WBC > 2400/ul or Granulocytes > 2000/ul and Platelets > 60.000/ul. Exclude DIC (disseminated intravascular coagulation).

-  Assess renal function to tailor tracer dose.

References:

1 Olea E.G. and Massardo T. Terapia radioisotópica paliativa en el dolor óseo de origen metastásico, p: 563 -569 in: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.

2 Silberstein E. B. Procedure Guideline for Bone Pain Treatment 2.0 p:111-116. Society of Nuclear Medicine, 2002.

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