Whole Body Sestamibi and FDG PET Scans
- 99mTc-sestamibi, 18FDG-PET and PET/CT are all useful additional diagnostic tools for detecting occult myeloma-related lesions. Sestamibi scans correlate well with disease activity. 17 PET/CT is a relatively new modality which overcomes the problem of spatial resolution with PET alone by combining with CT. This fusion scan demonstrates a sensitivity of 85% for the detection of myeloma deposits. 18
- In comparison to MRI, both sestamibi and PET/CT scans show a lower sensitivity for the detection of bone lesions. 19
- Based on current guidelines, neither sestamibi or PET scans are recommended for routine use in the diagnosis and management of myeloma patients. 10 However, both modalities may be useful to clarify the findings on previous imaging in selected cases, although further studies are required to support this role.
- Traditional technetium bone scintigraphy may detect up to 60% of lytic lesions in myeloma. However, it demonstrates a lower sensitivity and specificity compared to plain radiography which is due to osteoblastic dysfunction in myeloma. 10 Other modalities should be used in preference in the diagnosis and monitoring of patients.
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