Tc-99m MIBI scintigraphy in multiple myeloma: prognostic value of different Tc-99m MIBI uptake patterns.
OBJECTIVE
Technetium-99m 2 methoxyisobutylisonitrile (Tc-99m MIBI) scintigraphy has been used to identify biologic activity and extent of multiple myeloma (MM) and monoclonal gammopathy of unknown significance (MGUS). The examination could also serve both as a prognostic tool and an examination for monitoring the disease course in MM patients. The purpose of this study was to evaluate the prognostic value of different Tc-99m MIBI uptake patterns.


METHODS
Ninety-nine consecutive patients with newly diagnosed symptomatic MM and 18 patients with MGUS underwent baseline Tc-99m MIBI scintigraphy before applying any kind of therapy. The Tc-99m MIBI scans were classified as showing normal, diffuse, and focal or combined (diffuse and focal) patterns of tracer uptake. To evaluate the prognostic value of different Tc-99m MIBI uptake patterns, overall survival (OS) was chosen as an end point. Median of follow-up period was 84 months. Survival according to patterns of Tc-99m MIBI uptake was calculated using the Kaplan-Meier plots.


RESULTS
Statistically significant correlation between the baseline patterns of Tc-99m MIBI uptake and OS was found (P < 0.0001). Focal or combined patterns of Tc-99m MIBI uptake indicated significantly worse prognosis with shorter OS than normal or diffuse tracer patterns.


CONCLUSIONS
Tc-99m MIBI scintigraphy plays the predictive role in the follow-up of patients with MM. Baseline scintigraphic pattern of Tc-99m MIBI uptake seems to be a useful prognostic indicator of OS in MM patients and Tc-99m MIBI scintigraphy could be used as an additional tool for the initial examination in patients with newly diagnosed MM.
Bacovsky
Jaroslav
J
3rd Clinic of Internal Medicine, Medical Faculty and University Hospital, Olomouc, Czech Republic. bacovskyj@post.cz
Myslivecek
Miroslav
M
Scudla
Vlastimil
V
Koranda
Pavel
P
Buriankova
Eva
E
Minarik
Jiri
J
Pika
Tomas
T
Zapletalova
Jana
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging*; D010265:Paraproteinemias / Q000000981:diagnostic imaging; D011379:Prognosis; D011877:Radionuclide Imaging; D016019:Survival Analysis; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics*
D017256:Technetium Tc 99m Sestamibi