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Multiple myeloma: predictive value of Tc-99m MIBI scintigraphy and MRI in its diagnosis and therapy
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Abstract
MATERIAL AND METHODS: Forty-seven consecutive patients with MM and 5 with MGUS were enrolled in the study. Out of 47 MM patients, 6 were in Durie-Salmon stage I and 41 had active disease in stage II or III. Fifteen patients were examined before and within 2 months of intensive chemotherapy. Anterior and posterior whole-body scans were obtained 10 min after IV administration of 740 MBq (20 mCi) 99mTc-MIBI. MRI of Th and LS spine, T1 w.i. and STIR in the sagittal plane were performed.
RESULTS: Bone marrow pathological changes in 41 MM patients with active disease were detected in 39 (95%) scintigraphic examinations and in 38 (94%) of MRI. Among 41 MM patients with active disease, 21 showed diffuse patterns of 99mTc-MIBI uptake, 8 showed focal patterns and 10 showed both focal and diffuse patterns, while 34 patients exhibited focal lesions in MRI and 4 both focal and diffuse findings. Moreover, 5 of 38 patients had epidural mass and 18 had vertebrae compression. Out of 15 patients after therapy, 13 reached complete remission and 2 had stable disease. Normal 99mTc-MIBI scintigraphy was found in 11 (85%) patients with complete remission, 2 presented both focal and diffuse patterns of 99mTc-MIBI uptake. Two patients with stable disease also had focal and diffuse radiotracer uptake. MRI findings were normal only in 3 (23%) patients in complete remission. Eight patients exhibited focal lesions and 2 showed partial conversion in MRI.
CONCLUSIONS: 99mTc-MIBI scintigraphy and MRI are methods of equal sensitivity in detecting active MM and complement each other. The advantage of 99mTc-MIBI scintigraphy is the possibility of whole body examination, which allows superiority in detection of MM in appendicular skeleton and extramedular lesions, and faster response to therapy, while the advantage of MRI is the detection of epidural masses and vertebral compressions influencing the therapeutic strategy.
Abstract
MATERIAL AND METHODS: Forty-seven consecutive patients with MM and 5 with MGUS were enrolled in the study. Out of 47 MM patients, 6 were in Durie-Salmon stage I and 41 had active disease in stage II or III. Fifteen patients were examined before and within 2 months of intensive chemotherapy. Anterior and posterior whole-body scans were obtained 10 min after IV administration of 740 MBq (20 mCi) 99mTc-MIBI. MRI of Th and LS spine, T1 w.i. and STIR in the sagittal plane were performed.
RESULTS: Bone marrow pathological changes in 41 MM patients with active disease were detected in 39 (95%) scintigraphic examinations and in 38 (94%) of MRI. Among 41 MM patients with active disease, 21 showed diffuse patterns of 99mTc-MIBI uptake, 8 showed focal patterns and 10 showed both focal and diffuse patterns, while 34 patients exhibited focal lesions in MRI and 4 both focal and diffuse findings. Moreover, 5 of 38 patients had epidural mass and 18 had vertebrae compression. Out of 15 patients after therapy, 13 reached complete remission and 2 had stable disease. Normal 99mTc-MIBI scintigraphy was found in 11 (85%) patients with complete remission, 2 presented both focal and diffuse patterns of 99mTc-MIBI uptake. Two patients with stable disease also had focal and diffuse radiotracer uptake. MRI findings were normal only in 3 (23%) patients in complete remission. Eight patients exhibited focal lesions and 2 showed partial conversion in MRI.
CONCLUSIONS: 99mTc-MIBI scintigraphy and MRI are methods of equal sensitivity in detecting active MM and complement each other. The advantage of 99mTc-MIBI scintigraphy is the possibility of whole body examination, which allows superiority in detection of MM in appendicular skeleton and extramedular lesions, and faster response to therapy, while the advantage of MRI is the detection of epidural masses and vertebral compressions influencing the therapeutic strategy.
Keywords
multiple myeloma; 99mTc-MIBI scintigraphy; MRI; prediction of therapy effect
Title
Multiple myeloma: predictive value of Tc-99m MIBI scintigraphy and MRI in its diagnosis and therapy
Journal
Issue
Pages
12-16
Published online
2008-01-15
Page views
578
Article views/downloads
1419
DOI
10.5603/nmr.v11i1.15228
Bibliographic record
Nucl. Med. Rev 2008;11(1):12-16.
Keywords
multiple myeloma
99mTc-MIBI scintigraphy
MRI
prediction of therapy effect
Authors
Miroslav Myslivecek
Josef Nekula
Jaroslav Bacovsky
Vlastimil Scudla
Pavel Koranda
Milan Kaminek