Comparison of Technetium-99m-MIBI imaging with MRI for detection of spine involvement in patients with multiple myeloma.
BACKGROUND: Recently, radiopharmaceutical scanning with Tc-99m-MIBI was reported to depict areas with active bone disease in multiple myeloma (MM) with both high sensitivity and specificity. This observation was explained by the uptake of Tc-99m-MIBI by neoplastic cells. The present investigation evaluates whether Tc-99m-MIBI imaging and magnetic resonance imaging (MRI) perform equally well in detecting myelomatous bone marrow lesions. METHODS: In 21 patients with MM, MRIs of the vertebral region TH12 to S1 and whole body scans with Tc-99m-MIBI were done. RESULTS: Tc-99m-MIBI scanning missed bone marrow infiltration in 43 of 87 vertebrae (50.5%) in which MRI showed neoplastic bone marrow involvement. In patients with disease stage I+II, Tc-99m-MIBI scanning was negative in all of 24 vertebrae infiltrated according to MRI. In patients with disease stage III, Tc-99m-MIBI scanning detected 44 of 63 (70%) vertebrae involved by neoplastic disease. CONCLUSION: Tc-99m-MIBI scanning underestimated the extent of myelomatous bone marrow infiltration in the spine, especially in patients with low disease stage.
Mirzaei
Siroos
S
1st Department of Medicine and Medical Oncology, Wilhelminenspital, Vienna, Austria. Martin.Pecherstorfer@1me.wil.magwien.gv.at
Filipits
Martin
M
Keck
Andrea
A
Bergmayer
Walter
W
Knoll
Peter
P
Koehn
Horst
H
Ludwig
Heinz
H
Pecherstorfer
Martin
M