Can Pagets disease be distinguished from cancer in the bones on nuclear medicine studies

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Can Pagets disease be distinguished from cancer in the bones on nuclear medicine studies?

Paget’s disease typically is associated with focal areas of intensely increased radiotracer uptake in the flat bones or in the ends of the long bones. The uptake is usually diffuse, although there can be focal areas of increased uptake. There is no definitive way to distinguish metastatic disease or primary bone tumors from Paget’s disease on the basis of radiotracer uptake in the bones alone. The pattern of Paget’s disease in terms of its distribution and appearance may help in the diagnosis, however. It is less likely that an individual would have an entire hemipelvis as the only site of metastatic disease, but this can commonly be a presentation of Paget’s disease

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