99mTc-sestamibi SPECT/CT and 18F-FDG-PET/CT Have Similar Performance but Different Imaging Patterns in Newly Diagnosed Multiple Myeloma

Overview

Journal Nucl Med Commun

Specialty Nuclear Medicine

Date 2020 Aug 1

PMID 32732603

Citations 8

Authors

Camila Mosci

Fernando V Pericole

Gislaine B Oliveira

Marcia T Delamain

Maria E S Takahashi

Jose Barreto C Carvalheira

Elba C S C Etchebehere

Allan O Santos

Eliana C M Miranda

Mariana C L Lima

Barbara J Amorim

Carmino A De Souza

Irene Lorand-Metze

Celso D Ramos

Affiliations

Soon will be listed here.

Abstract

Purpose: F-fluorodeoxiglucose (F-FDG)-PET/CT has been widely used to evaluate multiple myeloma. Tc-sestamibi (MIBI) scintigraphy has also been proposed for assessing multiple myeloma, but its use with state-of-the-art single-photon emission computed tomography/computed tomography (SPECT/CT) technology has not been fully evaluated.This study aimed to compare these two imaging modalities in multiple myeloma staging.

Materials And Methods: Sixty-two patients with recently diagnosed multiple myeloma were submitted to whole-body F-FDG-PET/CT and whole-body MIBI scans plus SPECT/CT of the chest and abdomen/pelvis. Number of focal lesions, contiguous soft tissue involvement (CSTI), extramedullary lesions (EMLs) and diffuse bone marrow (BM) involvement were recorded.

Results: PET/CT was positive in 59 patients (95%) and MIBI SPECT/CT in 58 (93%) (P = 0.69). MIBI detected more diffuse bone marrow involvement than PET/CT (respectively 78 vs. 58% of the patients), while PET/CT demonstrated more focal lesions than MIBI SPECT/CT (81 vs. 54% of the patients) (P = 0.002). PET/CT detected EMLs in four subjects and MIBI in one subject. CSTI was found in 28 (45%) and 23 (37%) patients on PET/CT and MIBI images, respectively (P = 0.36). Three patients with lytic lesions and no FDG uptake were MIBI positive, and two subjects with lytic lesions without MIBI uptake were FDG positive.

Conclusion: MIBI SPECT/CT performs similarly to F-FDG-PET/CT in identifying sites of active disease in multiple myeloma staging. MIBI is more efficient than FDG for detecting the diffuse involvement of bone marrow but less efficient for detecting focal lesions. Some patients presented a 'mismatch' pattern of FDG/MIBI uptake.

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