Comparison of bone scintigraphy and radiography in multiple myeloma

Radionuclide images and skeletal radiographs of 51 patients with multiple myeloma were compared to assess the sensitivity of scintigraphy in detecting radiographically evident disease. Comparable studies were available for 562 sites. The radionuclide image was relatively insensitive in detecting myeloma; it failed to show radiographically evident disease or underestimated its extent at 27% of the sites. On a limited number of serial images there were 7 sites at which a scintigraphic abnormality preceded the radiographic abnormality. No definite correlation was found between scintigraphic findings and hematologic parameters of myeloma activity. Although the radionuclide image may demonstrate a few sites of myeloma before the radiograph, radiography remains the primary method of evaluating skeletal involvement by myeloma.