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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
Author(s) -
Mele Anna,
Offidani Massimo,
Visani Giuseppe,
Marconi Monica,
Cambioli Filippo,
ni Marco,
Catarini Massimo,
Brianzoni Ernesto,
Berbellini Alfonso,
Ascoli Giorgio,
Brunori Marino,
Agostini Vanessa,
Corvatta Laura,
Isidori Alessandro,
Spinelli Aureliano,
Gradari Marinella,
Leoni Pietro
Publication year - 2007
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2006.06489.x
Subject(s) - medicine , multiple myeloma , asymptomatic , technetium tc 99m sestamibi , multivariate analysis , nuclear medicine , scintigraphy , bone marrow , radiology , technetium (99mtc) sestamibi , technetium , univariate analysis
Summary 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.