Technetium-99m sestamibi scintigraphy is sensitive and specific for the staging and the follow-up of patients with multiple myeloma: a multicentre study on 397 scans.
We evaluated the additional benefit of Technetium(99)-sestamibi (99mTc-MIBI) scanning in comparison with standard X-ray techniques for multiple myeloma patients either at diagnosis or during follow-up. Between February 2001 and January 2005, 397 whole body scans were acquired. On 229 scans performed at diagnosis, 146 (64%) were positive and 81 cases have discordant X-ray results. The sensitivity of 99mTc-MIBI and X-ray were 77% and 45% respectively. As a result of 99mTc-MIBI, 40% of asymptomatic myeloma patients were up-staged. The positivity of 99mTc-MIBI correlated significantly with all of the most relevant clinical and biological parameters. Multivariate analysis selected only high reactive C protein (P = 0.0005), bone marrow infiltration (P = 0.02) and bone pain (P = 0.002) as factors affecting 99mTc-MIBI pattern. In 22 patients with solitary myeloma, 99mTc-MIBI was positive in 86% of cases and detected more disease sites than X-ray. Among 168 scans performed during follow-up, 99mTc-MIBI presented high specificity in patients showing a complete response (CR; 86%), and correlated with myeloma activity and with response to therapy. At multivariate analysis, a positive pattern correlated with bone marrow infiltration (P = 0.002) and disease status other than CR (P = 0.03). We conclude that 99mTc-MIBI scanning is an additional diagnostic tool with a high specificity for the staging and the follow-up of multiple myeloma patients.
Mele
Anna
A
Department of Haematology, San Salvatore Hospital, Pesaro, Italy.
Offidani
Massimo
M
Visani
Giuseppe
G
Marconi
Monica
M
Cambioli
Filippo
F
Nonni
Marco
M
Catarini
Massimo
M
Brianzoni
Ernesto
E
Berbellini
Alfonso
A
Ascoli
Giorgio
G
Brunori
Marino
M
Agostini
Vanessa
V
Corvatta
Laura
L
Isidori
Alessandro
A
Spinelli
Aureliano
A
Gradari
Marinella
M
Leoni
Pietro
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D002097:C-Reactive Protein; D017256:Technetium Tc 99m Sestamibi