Tc-99m-MIBI scintigraphy in untreated stage III multiple myeloma: comparison with X-ray skeletal survey and bone scintigraphy

Alper E. , Gurel M., Evrensel T. , Ozkocaman V. , Akbunar T. , Demiray M.

NUCLEAR MEDICINE COMMUNICATIONS, vol.24, no.5, pp.537-542, 2003 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 24 Issue: 5
  • Publication Date: 2003
  • Doi Number: 10.1097/00006231-200305000-00009
  • Page Numbers: pp.537-542


Technetium-99m 2-methoxyisobutylisonitrile (Tc-99m-MIBI) is a lipophilic agent that has been proposed as a useful tracer for the detection of disease sites in patients with multiple myeloma (MM). We performed a prospective study to determine the potential of Tc-99m-MIBI imaging for the evaluation of the extent of primary disease in patients with advanced stage MM, compared with skeletal survey and bone scintigraphy. Twenty patients with advanced stage MM at initial diagnosis underwent whole-body Tc-99m-MIBI imaging, together with contemporaneous skeletal survey and bone scintigraphy. The findings of Tc-99m-MIBI imaging were correlated with the results of skeletal survey and bone scan. All Tc-99m-MIBI scans were positive for the presence of active MM whereas skeletal surveys were positive in 18 patients (90%) with osteolytic lesions. Bone scintigraphy demonstrated MM in only 15 patients (75%). In two patients with no detectable lesions on skeletal survey, Tc-99m-MIBI imaging revealed uptake in the spine, corresponding to the abnormalities seen on magnetic resonance imaging (MRI). With respect to the localization of bone lesions, Tc-99m-MIBI imaging was superior to bone scintigraphy in 15 patients (75%) and had concordant results with bone scintigraphy in four (20%). Tc-99m-MIBI imaging is a very sensitive imaging modality for the identification of the extent of disease in patients with advanced MM. It is clearly superior to bone scintigraphy and complements the results of skeletal survey by finding additional disease sites. Hence, in active MM patients, Tc-99m-MIBI imaging has the potential to detect bone marrow disease that cannot be detected by skeletal survey and bone scintigraphy. ((C) 2003 Lippincott Williams Wilkins).