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Open Access Highly Accessed Research article

Comparison of Technetium-99m-MIBI imaging with MRI for detection of spine involvement in patients with multiple myeloma

Siroos Mirzaei1, Martin Filipits4, Andrea Keck2, Walter Bergmayer3, Peter Knoll1, Horst Koehn1, Heinz Ludwig2 and Martin Pecherstorfer2*

Author Affiliations

1 Ludwig Boltzmann Institute of Nuclear Medicine, Wilhelminenspital, Vienna, Austria

2 1st Department of Medicine and Medical Oncology, Wilhelminenspital, Vienna, Austria

3 Department of Radiology, Wilhelminenspital, Vienna, Austria

4 Division of Oncology, Department of Internal Medicine I, University of Vienna, Vienna, Austria

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BMC Nuclear Medicine 2003, 3:2  doi:10.1186/1471-2385-3-2

Published: 11 December 2003

Abstract

Background

Recently, radiopharmaceutical scanning with Tc-99m-MIBI was reported to depict areas with active bone disease in multiple myeloma (MM) with both high sensitivity and specificity. This observation was explained by the uptake of Tc-99m-MIBI by neoplastic cells. The present investigation evaluates whether Tc-99m-MIBI imaging and magnetic resonance imaging (MRI) perform equally well in detecting myelomatous bone marrow lesions.

Methods

In 21 patients with MM, MRIs of the vertebral region TH12 to S1 and whole body scans with Tc-99m-MIBI were done.

Results

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.

Conclusion

Tc-99m-MIBI scanning underestimated the extent of myelomatous bone marrow infiltration in the spine, especially in patients with low disease stage.