title: Correlation between the uptake of Tc-99m-sestaMIBI and prognostic factors in patients with multiple myeloma.
abstract: Technetium 99m-2-methoxyisobutil-isonitrile (Tc-99m-MIBI), also called sestaMIBI, has been used successfully to detect malignant tumours at diagnosis. Recently, it has been proposed as a safe and effective tracer in patients with multiple myeloma (MM). The purpose of this study was to demonstrate the value of the Tc-99m-MIBI uptake in disease detection and to assess the correlation between the uptake of this scintigraphy agent and prognostic factors in newly diagnosed MM patients. Thirty-five untreated patients were enrolled in the study. Tc-99m-MIBI scanning was performed in 33 patients after intravenous injection of 7.4 MBq/kg. Whole-body anterior and posterior scans were obtained after 30 min, 60 min, 2 and 4 h. The correlation between known prognostic factors of MM and the intensity of Tc-99m-MIBI uptake was assessed. Our results showed seven patients with an intensity score of I0, 12 patients with I1, eight patients with I2 and six patients with a score of I3. There was a positive correlation between Tc-99m-MIBI intensity and C-reactive protein (CRP; r=0.506, P < 0.01), erythrocyte sedimentation rate (ESR; r=0.368, P < 0.05), beta2- microglobulin (beta2M; r=0.749, P < 0.001), interleukin-6 (IL-6; r=0.823, P < 0.001), soluble Interleukin-6 receptor (sIL-6r; r=0.806, P < 0.001), serum calcium (r=0.578, P < 0.001) and bone alkaline phosphatase (BAP; r=0.472, P < 0.01). An inverse correlation was found between Tc-99m-MIBI intensity and osteocalcin (OC) and type I procollagen carboxyterminal propeptide (PICP). In conclusion, the results of this study suggest that more extensive disease activity, as determined by high levels of CRP, beta2M, IL-6 and sIL-6r correlated with a higher uptake of the radiotracer.
authors.affiliation: Department of Haematology, University Hospital of Heraklion, Crete, Greece. karkavit@edu.uch.gr
authors.forename: M G
authors.initials: MG
authors.lastname: Alexandrakis
authors.forename: D S
authors.initials: DS
authors.lastname: Kyriakou
authors.forename: F H
authors.initials: FH
authors.lastname: Passam
authors.forename: N
authors.initials: N
authors.lastname: Malliaraki
authors.forename: A V
authors.initials: AV
authors.lastname: Christophoridou
authors.forename: N
authors.initials: N
authors.lastname: Karkavitsas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D010014:Osteolysis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D011379:Prognosis; D018709:Statistics, Nonparametric; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics*; D014055:Tomography, Emission-Computed
chemical_list: D015415:Biomarkers; D017256:Technetium Tc 99m Sestamibi