Technetium-99m sestamibi scanning in multiple myeloma stem cell transplantation

Abstract

We report the use of technetium-99m sestamibi (MIBI) in a patient with multiple myeloma (MM) undergoing peripheral blood stem cell (PBSC) transplantation. MIBI is a radionuclide agent that is preferentially taken up by malignant tumors. Plain radiographs in a MM patient, taken prior to PBSC transplantation, showed a large right humeral lytic lesion that correlated with increased uptake of MIBI at the same location. MIBI uptake, demonstrating active MM bone disease, was also evident in areas which were normal on plain radiographs. Three months after PBSC transplant, the lytic lesion had healed by plain radiographs and repeat MIBI scan showed no uptake. MIBI scanning results have a positive correlation with plain radiographs, and more importantly, demonstrate active MM bone disease not yet detectable by plain radiographs. If MIBI proves more sensitive in the detection of MM bone disease than plain radiographs or bone scanning with traditional isotopes, it will have a significant role in the detection of early disease and in monitoring disease progression during and after therapy.

Technetium-99m-sestamibi scintigraphy: an alternative approach for diagnosis and follow-up of active myeloma lesions after high-dose chemotherapy and autologous stem cell transplantation

“…The results are comparable to those found with MRI [1]. As this study and others [15] showed that MIBI scanning correlates very well with clinical outcome, it is a good complement of other biological parameters for assessing the bone situation after stem cell transplantation. The reappearance of bone lesions after transplantation with a negative pre-exam is a clear, sometimes a first indication of subsequent relapse.…”

“…There are a few reports in the literature [8,15,18,22] demonstrating its usefulness in the diagnosis of MM and only few MIBI data are available for follow-up after high-dose therapy. The great advantage of this method is the detection of biologically active areas [8].…”

“…As a liposoluble monovalent cation, it passes through cytoplasmic and mitochondrial membranes along the electric gradient [11]. Only few data are available regarding MIBI scanning in multiple myeloma (MM) [8,15,18,22], and the rationale for the MIBI scan would be to document the biological activity of plasma cells [8].…”

Comparison of technetium-99m sestamibi and indium-111 octreotide imaging in a patient with ewing's sarcoma before and after stem cell transplantation

“…Sensi-/ 7b94$$1468 11-20-97 08:38:54 canas W: Cancer metabolic demand of tumor cells may promote MIBI high dose chemotherapy and stem cell transplantation in a patient with multiple myeloma. 12 With respect to uptake. MIBI has been shown to be taken up by various malignant tumors, including breast carcinoma, bone lesions, the uptake by malignant bone lesions is greater than that of benign bone lesions.…”

Focal MIBI uptake is a better indicator of active myeloma than diffuse uptake

“…Malignant tumours maintain higher mitochondrial and plasma membrane potentials than most non‐malignant tissue, by virtue of their increased metabolic requirements, and hence demonstrate increased MIBI concentration (1, 2), which forms the basis for using MIBI in evaluating myeloma. Since 1996, a number of studies (3, 4) have explored the use of MIBI in multiple myeloma, and in comparison with skeletal radiography, MIBI demonstrated higher sensitivity and specificity in the detection of bone marrow involvement.…”