I shared your concern with the legaleze on bone scan reports, as well as the subjectivity of the test itself that is more of a Rorshack test vis a vis the F18 sodium test that is more discrete, and also usually performed by more experienced radiation technicians.
My March 2013 bone scan report said multiple thoracic bodies and right posterior ribs with no specific count. Could be 5 or 500, depending on what assumptions the reader makes.
Urologists are notoriously scared of reading the actual scans and not much better at it than us laymen. They wrongly inferred my body was riddled with stage IV PCa metastatic to bone T1cN0M1b.
Thanks to this site and Inspire.com I learned about
Oligometastasis <= 5 distant bone mets and was enrolled in Univ of Florida & Shands Metastatic Disease program.
Then during this past summer bone scan said no longer any evidence of bone metastasis. Either the Lupron from 3-28-13 cured it (w/o Casodex and any triple blockade) or I never had the mets in first place.
When I did the F18 sodium and C11 Acetate tests at AZ Molecular Imaging, Dr Fabio Almeida who does 3-4 of these a day says his review of old scans and new tests concludes I never had bony mets. The local doctors have a professional difference of opinion and prefer to think of it as Lupron cured me.
Regardless I went from T1CN0M1b stage IV treatable but not curable to stage III locally advanced PCa potentially cured with radiation T1cN1M0.
The F18 (covered by insurance) showed no bone mets but suspicion of Lymph Nodes and the C11 (Not covered by insurance usually $3000 out of pocket but got it for $2500 since I was also doing the F18) confirmed 3 micro LN's contained to pelvic region.
A recent 1.5T MRI with endorectal coil showed no Extracapsular Extension of prostatic tumor with normal appearance of the periprostatic fat planes, seminal vessels and neurovascular bundles.
The Johns Hopkins review of my Feb 2013 biopsy this summer confirmed G9 (4+5) and did not comment on original biopsy report of right perineural invasion (PNI).
So in my case I learned to not rely on local imaging firms in rural areas that only do a few PCa scans a month, mostly slip and fall bone fracture facility. I highly recommend Dr Fabio Almeida.
So I start Provenge Sept 19 and start SBRT Oct 6 at UCLA by Dr Chris King who has a two weeks every other day M-W-F week one and M-W week 2 and you're done for high risk G9's rather than the traditional IGRT/IMRT/EBRT low dose brachy or high dose HDR with a "Boost" that all encompass 7-9 weeks 5 fractions per week and more total radiation 79 gy - 81 Gy with no do-overs.
The SBRT is less than 40 Gy and if necessary a second zap could be done later.
The SBRT wraps up Oct 15 and the Provenge Oct 20, except for the abscopal effect that lasts much longer
prostate-cancer.org/the-abscopal-effect-and-the-prospect-of-using-cancer-against-itself/Obviously this is very advanced and not something I could have come up with on my own. Eternally grateful for Tall Allen who mentored me throughout the process.
LupronJim