%0 Journal Article
%T Comparison of Technetium-99m-MIBI imaging with MRI for detection of spine involvement in patients with multiple myeloma
%A Siroos Mirzaei
%A Martin Filipits
%A Andrea Keck
%A Walter Bergmayer
%A Peter Knoll
%A Horst Koehn
%A Heinz Ludwig
%A Martin Pecherstorfer
%J BMC Medical Physics
%D 2003
%I BioMed Central
%R 10.1186/1471-2385-3-2
%X In 21 patients with MM, MRIs of the vertebral region TH12 to S1 and whole body scans with Tc-99m-MIBI were done.Tc-99m-MIBI scanning missed bone marrow infiltration in 43 of 87 vertebrae (50.5%) in which MRI showed neoplastic bone marrow involvement. In patients with disease stage I+II, Tc-99m-MIBI scanning was negative in all of 24 vertebrae infiltrated according to MRI. In patients with disease stage III, Tc-99m-MIBI scanning detected 44 of 63 (70%) vertebrae involved by neoplastic disease.Tc-99m-MIBI scanning underestimated the extent of myelomatous bone marrow infiltration in the spine, especially in patients with low disease stage.The leading symptom of multiple myeloma (MM) is neoplastic bone involvement. Difficulties in diagnosing MM can arise from the fact that not all patients present with punched-out osteolytic lesions, the typical radiographic findings of MM. In 10¨C20% of patients with first diagnosis of MM, the skeletal x-rays are completely normal, and in up to 10% only osteoporosis-like changes can be detected. In contrast to skeletal radiography, which reveals the osseous destruction induced by myeloma cells, magnetic resonance imaging (MRI) directly depicts the initiator of bone lesions, myelomatous bone marrow infiltration [1]. Since bone marrow involvement can be visualized by MRI, even when the lytic lesions cannot be seen on skeletal radiographs, MRI has markedly improved the diagnosis and monitoring of MM [1]. Recently, radiopharmaceutical scanning with Technetium-99m 2 methoxy-isobutyl-isonitrile (Tc-99m-MIBI) was shown to demonstrate areas with active bone disease in MM with both high sensitivity and specificity [2-6]. Fonti et al. reported that myeloma cells directly take up Tc-99m-MIBI in vitro and that there is a close correlation between both the in vitro and in vivo uptake of the radiolabeled tracer and the bone marrow plasma cell infiltration shown by bone marrow aspiration [6]. Thus, Tc-99m-MIBI scanning reveals the presence of the infi
%U http://www.biomedcentral.com/1471-2385/3/2