Predictive value of technetium-99m sestamibi in patients with multiple myeloma and potential role in the follow-up(448 views) Pace L, Catalano L, Del Vecchio S, Di Gennaro F, De Renzo A, Sica G, Califano C, Tedesco N, Borrelli G, Rotoli B, Salvatore M
Keywords: 99mtc-Mibi Scintigraphy, Follow-Up, Multiple Myeloma, C Reactive Protein, Methoxy Isobutyl Isonitrile Technetium Tc 99m, Adult, Aged, Article, Cancer Chemotherapy, Cancer Regression, Clinical Article, Diagnostic Value, Disease Course, Disease Exacerbation, Drug Tumor Level, Female, Follow Up, Human, Prognosis, Disease Progression, Follow-Up Studies, Middle Aged, Predictive Value Of Tests, Radiopharmaceuticals, Technetium Tc 99m Sestamibi, Whole-Body Counting,
Affiliations: *** IBB - CNR ***
Cattedra di Medicina Nucleare, Facolta di Medicina e Chirurgia, Università Federico II, via Pansini 5, 80131 Napoli, Italy
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Malpas, J. S., Tirovola, E. B., Biassoni, L., Kaleva, N., Kouykin, V., Britton, K. E., Myeloma imaging with Tc-99m MIBI (1995) Proc. 5th international workshop on multiple myeloma, 3, p. 120. , La Baule, France, 10-13 September
Adams, B. K., Fataar, A., Nizami, M. A., Technetium-99m-sestamibi uptake in myeloma (1996) J Nucl Med, 37, pp. 1001-1002
El-Shirbiny, A. M., Yeung, H., Imbriaco, M., Michaeli, J., Macapinlac, H., Larson, S. M., Technetium-99m-MIBI versus fluorine-18-FDG in diffuse multiple myeloma (1997) J Nucl Med, 38, pp. 1208-1210
Salomon, S. E., Cassady, J. R., Plasma cell neoplasm (1997) Cancer - principles and practice of oncology, pp. 2344-2387. , De Vita VT Jr, Hellman SH, Rosenberg SA, eds. Philadelphia New York
Durie, B. G. M., Salmon, S. E., A clinical staging system for multiple myeloma: Correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival (1975) Cancer, 36, pp. 842-854
Carvalho, P. A., Chiu, M. L., Kronauge, J. F., Kawamura, M., Jones, A. G., Holman, L. B., Piwnica-Worms, D., Subcellular distribution and analysis of technetium-99m-MIBI in isolated perfused rat heart (1992) J Nucl Med, 33, pp. 1516-1522
Bom, H. S., Kim, Y. C., Song, H. C., Min, J. J., Kim, J. Y., Park, K. O., Technetium-99m-MIBI uptake in small cell lung cancer (1998) J Nucl Med, 39, pp. 91-94
Predictive value of technetium-99m sestamibi in patients with multiple myeloma and potential role in the follow-up
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, P<0.05). A negative baseline 99mTc-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, P<0.0001). Considering pattern N as indicating remission, pattern D stable condition, and pattern F or F+D progressive disease, a high concordance between scintigraphic findings and clinical status was found in the 22 patients undergoing chemotherapy (91%). Variation in 99mTc-MIBI findings comparing baseline and follow-up evaluations was significantly associated with clinical status both in patients undergoing chemotherapy (χ2=26.5, P<0.0005) and in those not undergoing chemotherapy (χ2=8.0, P<0.005). In conclusion, the results of this study suggest a prognostic value of 99mTc-MIBI scintigraphy in patients with MM and a potential role during the follow-up.
Predictive value of technetium-99m sestamibi in patients with multiple myeloma and potential role in the follow-up
Hesse B, Tagil K, Cuocolo A, Anagnostopoulos C, Bardies M, Bax J, Bengel F, Busemann Sokole E, Davies G, Dondi M, Edenbrandt L, Franken P, Kjaer A, Knuuti J, Lassmann M, Ljungberg M, Marcassa C, Marie PY, Mckiddie F, O'connor M, Prvuolovich E, Underwood R * 3. 0 T perfusion MR imaging(731 views) Rivista Di Neuroradiologia (ISSN: 1120-9976), 2004; 17(6): 807-812. Impact Factor:0.023 ViewExport to BibTeXExport to EndNote