Multimodality Molecular Imaging in Arthropathy Associated with Multiple Myeloma
Ludmila Santiago Almeida1, Stephan Pinheiro Macedo de Souza1, Fernando Vieira Pericole de Souza2
1Department of Radiology, Division of Nuclear Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.
This study highlights how technetium-99m-MIBI SPECT/CT and 18F-FDG PET/CT imaging can differentiate multiple myeloma involvement from amyloid arthropathy in large joints.
Area of Science:
- Nuclear medicine
- Oncology
- Rheumatology
Background:
- Multiple myeloma (MM) can present with polyarthritis, mimicking other joint conditions.
- Accurate diagnosis is crucial for appropriate MM and arthropathy management.
Purpose of the Study:
- To investigate the utility of 99mTc-MIBI SPECT/CT and 18F-FDG PET/CT in staging MM with polyarthritis.
- To differentiate MM bone marrow involvement from periarticular pathology.
Main Methods:
- A patient with MM and polyarthritis underwent staging with 99mTc-MIBI SPECT/CT and 18F-FDG PET/CT.
- Bone scintigraphy was also performed.
Main Results:
- 99mTc-MIBI SPECT/CT showed diffuse bone marrow involvement by MM.
- 18F-FDG PET/CT revealed intense uptake in periarticular tissues, not MM.
- Bone scintigraphy indicated radiolabeled bisphosphonate accumulation in periarticular tissues, suggestive of amyloid arthropathy.
Conclusions:
- 18F-FDG PET/CT and 99mTc-MIBI SPECT/CT have complementary roles in evaluating MM patients with joint pain.
- These imaging modalities can help distinguish MM infiltration from secondary amyloid arthropathy.
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