Washout of [99mTc] sestamibi in predicting response to chemotherapy in patients with multiple myeloma(381 views) Pace L, Catalano L, Del Vecchio S, De Renzo A, Fonti R, Salvatore B, Andretta C, Di Nuzzo C, Rotoli B, Salvatore M
Q J Nucl Med Mol Im (ISSN: 1824-4785, 1824-4478, 1824-4785linking), 2005 Sep; 49(3): 281-285.
Nuclear Medicine Unit, Department of Biomorphological and Functional Sciences, Federico II University, Naples, Italy
Institute of Biostructures and Bioimaging, CNR, Naples, Italy
Hematology Division, Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy
Medicina Nucleare, Dipartimento Scienze Biomorfologiche e Funzionali, Università degli Studi Federico II, via Pansini 5, 80131, Napoli, Italy
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Washout of [99mTc] sestamibi in predicting response to chemotherapy in patients with multiple myeloma
Aim. Technetium-99m 2-methoxy-isobutyl-isontrile ([99mTc] MIBI) has been successfully used to study patients with multiple myeloma (MM). This tracer is also substrate for P-glycoprotein (Pgp). Since Pgp overexpression is one of the primary mechanisms of multidrug resistance in MM, the aim of this study was to test whether [99mTc] MIBI could be an index of Pgp overexpression and function in MM and therefore predicts response to chemotherapy. Methods. Forty patients with MM (12 in stage I, 15 in stage II, and 13 in stage III) showing diffuse bone marrow [99mTc] MIBI uptake Were included in the study. All patients underwent whole body scintigraphy at 10 and 60 minutes after i.v injection of 555 MBq of [99mTc] MIBI. [99mTc]MIBI washout was measured, after decay correction, as: (10 minute counts pixel, computed on a region of interest drawn on the thoracic spine (posterior projection), taking care of avoiding heart and splancnic organs. Disease restaging was performed at a mean time of 32±20 months, and patients were considered to be in remission (complete or partial) or to show disease progression on the basis of a complete clinical and hematological evaluation. Result. Patients showing disease progression at restaging (n=26) had higher washout (19.3±9.8% vs 12.8±6.9%, p<0.05 than patient in remission (n=14). Disease free survival was significantly better in patient with lower washout of [99mTc] MIBI. No difference in therapeutic regimen and stage of disease at admission were found between the 2 groups. When patient treated with melphalan were excluded from the analysis, 87.5% of patient in remission had low washout. Conclusion. The present study suggests a potential role of [99mTc] MIBI washout in predicting response to chemotherapy in patients with MM.
Washout of [99mTc] sestamibi in predicting response to chemotherapy in patients with multiple myeloma