Detection of focal myeloma lesions by technetium-99m-sestaMIBI scintigraphy(305 views visite) Catalano L, Pace L, Califano C, Pinto AM, De Renzo A, Di Gennaro F, Del Vecchio S, Fonti R, Salvatore M, Rotoli B
Haematologica (ISSN: 0390-6078, 0006-4971, 0006-6497), 1998 Nov 15; 92(10): 119-124.
Keywords Parole chiave: 99mtc-Mibi, Bone Scintigraphy, Multiple Myeloma, Osteolysis, Methoxy Isobutyl Isonitrile Technetium Tc 99m, Adult, Aged, Article, Female, Human, Intravenous Drug Administration, Major Clinical Study, Monoclonal Immunoglobulinemia, Plasmacytoma, Whole Body Scintiscanning, 80 And Over, Bone Marrow Neoplasms, Diagnostic Imaging, Middle Aged, Radionuclide Imaging, Radiopharmaceuticals, Technetium Tc 99m Sestamibi,
Affiliations Affiliazioni: Ctro. C.N.R. per la Med. Nucleare, Napoli, Italy Cattedra di Ematologia, Università Federico II, via Pansini 5, 80131 Naples, Italy Ctro. C. N. R. per la Med. Nucleare, Napoli, Italy Dipartimento di Medicina Clinica e Sperimentale, Facolta di Medicina e Chirurgia, Universita Federico II, Napoli, Italy.,
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Pace, L., Catalano, L., Pinto, A.M., Different patterns of technetium-99m-sestaMIBI scintigraphy in multiple myeloma (1998) Eur J Nucl Med, 25, pp. 714-720
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Kao, C. H., Wang, S. J., Liu, T. J., The use of technetium-99m-methoxyisobutylisonitrile breast scintigraphy to evaluate palpable breast masses (1994) Eur J Nucl Med, 21, pp. 432-436
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Detection of focal myeloma lesions by technetium-99m-sestaMIBI scintigraphy
Background and Objective. The tracer technetium-99m-2-methoxy-isobutyl-isonitrile (Tc99m-sestaMIBI) has recently been shown to concentrate in some neoplastic tissues, including myeloma. We investigated the diagnostic capacity and limits of this procedure in tracing focal myeloma lesions, and compared them with those of conventional radiological procedures (Xr). Design and Methods. We studied 55 patients suffering from multiple myeloma (MM) or solitary plasmacytoma in different stages and clinical conditions, or from monoclonal gammopathy of undefined significance (MGUS), by whole body scans obtained 10 minutes after injection of 555 MBq of Tc99m-sestaMIBI. Scans were defined as normal (physiological uptake only), diffuse (presence of bone marrow uptake), or focal(localized areas of uptake), and were compared to conventional skeletal Xr. Results. Thirty patients showed no focal areas of Tc99m-sestaMIBI uptake; this group consisted of 5 patients with MGUS, 6 with MM in stage IA and 2 in stage IIA, 11 patients studied after effective chemotherapy and 6 in early relapse. Twenty-five patients showed one or more spots of focal uptake: all of them had active disease (untreated, resistant or relapsing MM). In the setting of tracing focal lesions, Tc99m-sestaMIBI scans were concordant with the radiological examination in 38 patients and discordant in 17. Among the latter, in 4 cases Tc99m-sestaMIBI revealed focal lesions not detected by Xr, and in 13 cases lytic areas detected by Xr did not show Tc99m-sestaMIBI uptake. Interpretation and Conclusions. In untreated patients, the number of lesions revealed by Tc99m-sestaMIBI was comparable to that shown by Xr, while in pretreated patients Tc99m-sestaMIBI traced a number of lesions lower than that detected by Xr. The reason for this discrepancy is that Tc99m-sestaMIBI traces only active lesions. Tc99m-sestaMIBI limitations in identifying focal lesions may derive from the dimension of the smallest traceable lesion (about one centimeter), and from the possibility that focal plasma cell localizations in collapsed bone may not be visualized due to inadequate vascularization. Tc99m-sestaMIBI scintigraphy is an interesting tool for diagnosing, staging and following up focal myeloma lesions, in the bone as well as in soft tissues. It is more specific than conventional Xr in identifying sites of active disease. (C)1999, Ferrata Storti Foundation.
Detection of focal myeloma lesions by technetium-99m-sestaMIBI scintigraphy
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