Comparison of bone scintigraphy and radiography in multiple myeloma.

Abstract

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.

Comparison of the Sensitivity of ^99mTc-Methyl Diphosphonate Bone Scan with the Skeletal X-Ray Survey in Multiple Myeloma

“…RSS appears to be superior to RIBS in PCD [26][27][28][29]. It was shown in several stud ies [9,28,30] that the RIBS detects about 50% of the lesions revealed by RSS, how ever, in our patients, this rate was even lower (fig 3a, b)!…”

Importance of quantitative histology of bone changes in monoclonal gammopathy

“…In both cases, at the cell level, the suppression of osteoblastic activity could be mediated by osteoclast activating factors themselves, able to inhibit collagen synthesis in vitro (Raisz et al, 1975), or by other soluble factors. This low osteoblastic activity in the vicinity of tumour sites could account for the poor value of bone scintigraphy in MM, illustrated by a lack of radioactive molecule uptake in about 50% of myeloma bone lesions (Woolfenden et al, 1980;.…”

Radionuclide imaging in histiocytosis X

“…As many histiocytosis X bone lesions are purely osteolytic without radiographic evident osseous reaction [14], a certain percentage of "cold" and false negative le- sions has to be expected in bone scanning. The situation is similar to that in multiple myeloma [2,7,10,19,34]. Especially, lesions in the proximity of growth plates or in the epiphysis will be difficult to detect, as the relatively high uptake in the epiphyseal growth plate will obscure lesions with decreased or slightly increased uptake.…”