Focal MIBI uptake is a better indicator of active myeloma than diffuse uptake

Abstract

Our study thus illustrates that the presence of any focal uptake of MIBI is useful in indicating active myeloma whereas diffuse uptake is not.

18F-FDG PET/CT, 99mTc-MIBI, and MRI in Evaluation of Patients with Multiple Myeloma

“…However, it should be noted that faint bone marrow uptake has been reported also in patients affected by pathologies other than MM (20). Nevertheless, when the intensity of diffuse 99m Tc-MIBI uptake was analyzed according to the criteria used by Pace et al (13), specificity improved significantly (20). False-negative cases by 99m Tc-MIBI may be due, rather, to the overexpression of P-glycoprotein (Pgp) that can be associated with multidrugresistant myeloma.…”

“…In fact, a previous study showed that moderateto-intense diffuse 99m Tc-MIBI uptake or focal uptake with or without diffuse uptake, in the absence of inflammation or other pathologies, excludes the diagnosis of monoclonal gammopathy of unknown significance (MGUS) and correlates with poor prognosis (19). However, it should be noted that faint bone marrow uptake has been reported also in patients affected by pathologies other than MM (20). Nevertheless, when the intensity of diffuse 99m Tc-MIBI uptake was analyzed according to the criteria used by Pace et al (13), specificity improved significantly (20).…”

“…In addition, 99m Tc-MIBI scans showed a high sensitivity and specificity in detecting sites of active disease and bone lesions (13). Despite several reports on the clinical usefulness of this imaging modality (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22), it is still unclear whether 99m Tc-MIBI can be fully replaced by 18 F-FDG PET/CT.…”

“…Moreover, previous studies have shown its usefulness in the detection of both osseous and extraosseous myeloma lesions (8)(9)(10). The lipophilic cation 99m Tc-MIBI has been successfully used for the detection of a variety of neoplastic diseases, including multiple myeloma, where it is reported to be useful in the assessment of disease extension both at diagnosis and during follow-up (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). MRI allows a direct high-contrast and sensitive visualization of the bone marrow and its components and, therefore, has become the method of choice for bone marrow imaging (23,24).…”

Role of Tc-99m sestamibi myocardial perfusion imaging in identifying multiple myeloma

“…10,11 Different patterns of Tc-99m sestamibi uptake have been characterized in multiple myeloma 12 and it has been shown that focal sestamibi uptake is a better indicator of active disease than diffuse uptake. 13 Tc-99m sestamibi imaging is also being increasingly utilized in the staging of the disease process as well as determination of remission in patients with multiple myeloma following chemotherapy. 12,14 Our case report reiterates the extracardiac diagnostic utility of Tc-99m sestamibi/MPI in identifying plasma cell disorders.…”