Tc-99m-sestamibi SPECT/CT and(18)F-FDG-PET/CT have similar performance but different imaging patterns in newly diagnosed multiple myeloma

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Mosci, Camila ; Pericole, Fernando V. ; Oliveira, Gislaine B. ; Delamain, Marcia T. ; Takahashi, Maria E. S. ; Carvalheira, Jose Barreto C. ; Etchebehere, Elba C. S. C. ; Santos, Allan O. ; Miranda, Eliana C. M. ; Lima, Mariana C. L. ; Amorim, Barbara J. ; de Souza, Carmino A. ; Lorand-Metze, Irene ; Ramos, Celso D.

• Document type: Journal article
• Source: NUCLEAR MEDICINE COMMUNICATIONS; v. 41, n. 10, p. 8-pg., 2020-10-01.

Abstract

Purpose F-18-fluorodeoxiglucose (F-18-FDG)-PET/CT has been widely used to evaluate multiple myeloma.Tc-99m-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(18)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(18)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. (AU)

• FAPESP's process: 18/14132-0 - EANM'18 - Annual Congress of the European AssociaBon of Nuclear Medicine
• Grantee: Celso Darío Ramos
• Support Opportunities: Research Grants - Meeting - Abroad
• FAPESP's process: 18/00654-4 - Comparison between Neovascularization and Cellular Hypermetabolism in Multiple Myeloma Using 68Ga-PSMA and 18F-FDG PET/CT Imaging - A Pilot Study
• Grantee: Celso Darío Ramos
• Support Opportunities: Regular Research Grants
• FAPESP's process: 09/54065-0 - Acquisition of a PET/CT for the quantification of metabolic activity in living tissue
• Grantee: Carmino Antonio de Souza
• Support Opportunities: Multi-user Equipment Program