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Bone scintigraphy has some limitations in detecting bone lesions at the time of diagnosis since Tc99m MDP scintigraphy does not trace lesions lacking osteoblastic activity3. Tc99m Sestamibi (MIBI) has been proposed as a potential tracer in patients with multiple myeloma, as its increased uptake in the bone marrow has been reported as an indicator of myeloma activity4. It has been suggested to be used in staging and follow up of patients with multiple myeloma with a high sensitivity and specificity5.

Value of Tc99m (V) Dmsa Compared to Tc99m Mibi in Evaluation of Bone and Bone Marrow Lesions in Patients with Multiple Myeloma.