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Journal of Nuclear Medicine Vol. 46 No. 6 978-982
© 2005 by Society of Nuclear Medicine

Brief Communications

Combined Use of 99mTc-Sestamibi and 99mTc-V-DMSA in the Assessment of Chemotherapy Effectiveness in Patients with Multiple Myeloma

John Koutsikos, MD1, Theodoros Athanasoulis, MD1, Athanasios Anagnostopoulos, MD2, Antigone Velidaki, MD3, Marianthi Passadi1, Meletios Athanasios Dimopoulos, MD, PhD2 and Cherry Zerva, MD, PhD1

1 Department of Nuclear Medicine, "Alexandra" University Hospital, Athens, Greece
2 Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece
3 Department of Nuclear Medicine, Livadia Medical Center, Livadia, Greece

ABSTRACT

This study determined the role of the combined use of 99mTc-sestamibi and 99mTc-pentavalent dimercaptosuccinic acid (V-DMSA) scintigraphy in evaluating the effectiveness of chemotherapy in patients with multiple myeloma. Methods: In 20 patients with multiple myeloma who had received or were receiving chemotherapy, 99mTc-sestamibi and 99mTc-V-DMSA scanning was performed to evaluate the effectiveness of chemotherapy. Results: In group A (11 patients with active disease), 42 99mTc-sestamibi–positive lesions were found. Thirty-seven of those lesions were also positive for 99mTc-V-DMSA uptake, as were 16 additional lesions (nonactive) (NAL). Thus, in group A, the total number of positive lesions (TPL) detected was 58 and the NAL/TPL ratio was 16:58. In group B (9 patients in remission), 5 99mTc-sestamibi–positive lesions were found. A further 22 lesions were also positive for 99mTc-V-DMSA uptake. Thus, in group B, the NAL/TPL ratio was 22:27. Therefore, the NAL/TPL ratios considered to represent effectively treated lesions were 27.6% and 81.5% for groups A and B, respectively. Conclusion: Combined use of the 2 agents allows the effectiveness of chemotherapy to be evaluated through a comparison of NAL and TPL multiple myeloma lesions even in the absence of a baseline study.

Key Words: 99mTc-MIBI • 99mTc-V-DMSA • multiple myeloma • chemotherapy • treatment






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Copyright © 2005 by the Society of Nuclear Medicine.