Diagnosis of Metastatic Bone Tumors X-ray of the entire bone Whole body radionuclide technecium-99 m bone scanning to identify metastases Advanced imaging (CT, MRI, and / or whole body PET-CT scanning for selected purposes) Clinical evaluation and testing to diagnose the primary tumor (if unknown) Often biopsy if the primary tumor is unknown after assessment Metastatic bone tumors are considered in all patients with unexplained bone pain, but particularly in patients who have Known cancer Pain or radiographic abnormalities at more than one site Findings on imaging studies that suggest metastases Prostate cancer is most often blastic, lung cancer is most often lytic, and breast cancer may be blastic or lytic.