Not done for bone metastasis detection:

Ans. D. UltrasoundExplanationImaging in Bone MetastasesPlain radiographs are often done as the first line investigation in patients with bone pain. However, radiography is considered insensitive to screen for asymptomatic metastases. The radiographic presence of such lesions very often lags behind their detectability by scintigraphy, CT or MRI.Plain radiographs are recommended to assess abnormal radionuclide uptake or the risk of pathological fracture.(Option a) MRI is the imaging modality of choice for assessing metastatic spread in the marrow cavity due to its excellent soft tissue resolution.(Option b) CT has excellent resolution of cortical and trabecular bone and is the imaging modality of choice for evaluating the ribs which have a high cortex to marrow ratio.(Option c) Radionuclide scan/bone scintigraphy is the imaging modality of choice in general for evaluation of bone metastases. Main agent used is metastable technetium 99 labeled diphosphonates, most commonly methylene diphosphonate ("mTc-MDP).(Option d) Ultrasound is not the imaging modality of choice in assessment of bony pathologies due to dense acoustic shadowing from bony surface.