Tc 99m Sestamibi Scanning in Multiple Myeloma--a New look with SPECT-CT

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Multiple myeloma diagnosis and staging rely on various tools like biochemistry and radiological imaging.
• Metabolic imaging, such as FDG PET, is a newer modality for assessing disease extent.

Purpose of the Study:

• To evaluate the diagnostic utility of Technetium-99m Sestamibi (Mibi) SPECT-CT for staging multiple myeloma.
• To compare Mibi SPECT-CT with conventional radiological assessments.

Main Methods:

• 112 whole-body Mibi SPECT-CT scans were performed on 84 patients with various stages of multiple myeloma.
• Images were analyzed for Mibi uptake, CT-detected lesions, and fused image interpretation.

Main Results:

• Myeloma lesions demonstrated significant Mibi uptake, with CT visualizing osteolytic lesions.
• Mibi uptake indicated active disease earlier than radiological changes and helped differentiate active from burnt-out lesions in follow-up cases.
• Whole-body scans detected additional lesions in Plasmacytoma patients, while MGUS patients showed minimal uptake.

Conclusions:

• Whole-body Sestamibi Imaging (WBSI) is a valuable tool for assessing multiple myeloma disease extent.
• Mibi SPECT-CT is superior to radiological assessment alone and serves as a cost-effective alternative to FDG PET when unavailable.