Bone marrow uptake of 99mTc-MIBI in patients with multiple myeloma

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Bone marrow uptake of 99mTc-MIBI in patients with multiple myeloma (98 visite)

Fonti R, Del Vecchio S, Zannetti A, De Renzo A, Di Gennaro F, Catalano L, Califano C, Pace L, Rotoli B, Salvatore M

Eur J Nucl Med (ISSN: 0340-6997, 1619-7070, 1619-7089), 2001; 28(2): 214-220.

Tipo di articolo: Journal Article,

Impact factor: 3.464, Impact factor a 5 anni: 4.728

Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-0035118907&partnerID=40&md5=2703a137bc8cdc0aaca0ee3aa021bf19

Parole chiave: 99mtc-Mibi, Multiple Myeloma, Uptake, Methoxy Isobutyl Isonitrile Technetium Tc 99m, Adult, Aged, Article, Autoradiography, Bone Marrow, Cell Infiltration, Cellular Distribution, Clinical Article, Controlled Study, Drug Tumor Level, Female, Human, Human Cell, Monoclonal Immunoglobulinemia, Radioactivity, Scintiscanning, Bone Marrow Cells, Middle Aged, Plasma Cells, Radiopharmaceuticals, Technetium Tc 99m Sestamibi, Whole-Body Counting,

Affiliazioni:

*** IBB - CNR ***
Medicina Nucleare, Facoltà di Medicina, Università Federico II, via S. Pansini 5 (edificio 10), 80131 Naples, Italy
Centro Per la Medicina Nucleare C.N.R., Cattedra di Medicina Nucleare, Università Federico II, Napoli, Italy
Cattedra di Ematologia, Dipartimento di Medicina Clinica e Sperimentale, Università Federico II, Napoli, Italy

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In a previous study, we showed the ability of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scan to identify active disease in patients with multiple myeloma (Eur J Nucl Med 1998; 25: 714-720). In particular, a semiquantitative score of the extension and intensity of bone marrow uptake was derived and correlated with both the clinical status of the disease and plasma cell bone marrow infiltration. In order to estimate quantitatively 99mTc-MIBI bone marrow uptake and to verify the intracellular localization of the tracer, bone marrow samples obtained from 24 multiple myeloma patients, three patients with monoclonal gammopathy of undetermined significance (MGUS) and two healthy donors were studied for in vitro uptake. After centrifugation over Ficoll-Hypaque gradient, cell suspensions were incubated with 99mTc-MIBI and the uptake was expressed as the percentage of radioactivity specifically retained within the cells. The cellular localization of the tracer was assessed by micro-autoradiography. Twenty-two out of 27 patients underwent 99mTc-MIBI scan within a week of bone marrow sampling. Whole-body images were obtained 10 min after intravenous injection of 555 MBq of the tracer; the extension and intensity of 99mTc-MIBI uptake were graded using the semiquantitative score. A statistically significant correlation was found between in vitro uptake of 99mTc-MIBI and both plasma cell infiltration (Pearson's coefficient of correlation r=0.69, P<0.0001) and in vivo score (Spearman rank correlation coefficient r=0.60, P<0.01). No specific tracer uptake was found in bone marrow samples obtained from the two healthy donors. Micro-autoradiography showed localization of 99mTc-MIBI inside the plasma cells infiltrating the bone marrow. Therefore, our findings show that the degree of tracer uptake both in vitro and in vivo is related to the percentage of infiltrating plasma cells which accumulate the tracer in their inner compartments.

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