Predictive value of technetium-99m sestamibi in patients with multiple myeloma and potential role in the follow-up

L. Pace, L. Catalano, S. Del Vecchio, F. Di Gennaro, A. De Renzo, G. Sica, C. Califano, N. Tedesco, G. Borrelli, B. Rotoli, M. Salvatore

Research output: Contribution to journalArticle

Abstract

Technetium-99m 2-methoxyisobutylisonitrile (99mTc-MIBI or setamibi) has recently been proposed for use in the evaluation of multiple myeloma (MM). The aims of this study were to investigate its potential predictive value in patients with MM and its possible role in the follow-up. Thirty patients with MM who had undergone two 99mTc-MIBI scintigraphic studies at least 2 months apart constituted the study group; 22 of them received chemotherapy in the interval between the two scans. The scans were classified as showing pattern N when only physiological uptake was present, pattern D when diffuse bone marrow uptake was observed, pattern F when areas of focal uptake of the tracer were evident, and pattern F+D when both D and F patterns were observed. Comparative 99mTc-MIBI scintigraphy was considered indicative of disease progression when there was a worsening of the pattern (i.e. from N to D, or from N or D to F or to F+D) or an increase in the pattern D semiquantitative score. It was considered indicative of disease improvement when the opposite trend was observed; otherwise, it was considered to document a stable condition. A significant association was observed between the baseline scintigraphic pattern and clinical status at follow-up in the group of patients evaluated after chemotherapy (χ2=16.7, P99mTc-MIBI scintigram showed a high predictive accuracy (100%) for remission, while the presence of pattern F or F+D was often associated with a less favourable outcome. A multivariate analysis showed that 99mTc-MIBI uptake pattern has an added value in relation to known prognostic variables such as C-reactive protein. 99mTc-MIBI scintigraphy patterns at follow-up were significantly associated with the clinical status evaluated after chemotherapy (χ2=32.6, P99mTc-MIBI findings comparing baseline and follow-up evaluations was significantly associated with clinical status both in patients undergoing chemotherapy (χ2=26.5, P2=8.0, P99mTc-MIBI scintigraphy in patients with MM and a potential role during the follow-up.

Original languageEnglish
Pages (from-to)304-312
Number of pages9
JournalEuropean Journal Of Nuclear Medicine
Volume28
Issue number3
DOIs
Publication statusPublished - 2001

Keywords

  • Tc-MIBI scintigraphy
  • Follow-up
  • Multiple myeloma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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