Detection of recurrent malignant melanoma with 99mTc-MIBI scintigraphy

Technetium-99m sestamibi scintigraphy is sensitive and specific for the staging and the follow-up of patients with multiple myeloma: a multicentre study on 397 scans

We evaluated the additional benefit of Technetium(99)-sestamibi (99mTc-MIBI) scanning in comparison with standard X-ray techniques for multiple myeloma patients either at diagnosis or during follow-up. Between February 2001 and January 2005, 397 whole body scans were acquired. On 229 scans performed at diagnosis, 146 (64%) were positive and 81 cases have discordant X-ray results. The sensitivity of 99mTc-MIBI and X-ray were 77% and 45% respectively. As a result of 99mTc-MIBI, 40% of asymptomatic myeloma patients were up-staged. The positivity of 99mTc-MIBI correlated significantly with all of the most relevant clinical and biological parameters. Multivariate analysis selected only high reactive C protein (P = 0.0005), bone marrow infiltration (P = 0.02) and bone pain (P = 0.002) as factors affecting 99mTc-MIBI pattern. In 22 patients with solitary myeloma, 99mTc-MIBI was positive in 86% of cases and detected more disease sites than X-ray. Among 168 scans performed during follow-up, 99mTc-MIBI presented high specificity in patients showing a complete response (CR; 86%), and correlated with myeloma activity and with response to therapy. At multivariate analysis, a positive pattern correlated with bone marrow infiltration (P = 0.002) and disease status other than CR (P = 0.03). We conclude that 99mTc-MIBI scanning is an additional diagnostic tool with a high specificity for the staging and the follow-up of multiple myeloma patients.

[Examination of regional limph nodes in penile carcinoma by 99M Tc-MIBI scintigraphy]

99mTc-MIBI scintigraphy has proven utility as a clinically valuable technique for the diagnosis of various primary and recurrent malignant lesions. We report the case of a 65 year old man with penile squamous cell carcinoma and clinically questionable bilateral inguinal lymph nodes. 99mTc-MIBI scan shows increased focal uptake in both groins and in the right iliac region. The patient underwent penile amputation with bilateral lymphadenectomy. Histopathologic report revealed metastatic lymph nodes in all lymphatic basins seen with 99mTc-MIBI. We conclude that this technique has the potential of supplying clinically relevant information for the diagnosis of regional extension of patients with penile carcinoma.

The role of technetium-99m methoxyisobutyl isonitrile scintigraphy in suspected recurrent breast cancer

The aim of this study was to determine the role of technetium-99m methoxyisobutyl isonitrile (99mTc-MIBI) scintigraphy in the evaluation of recurrence and metastases in breast cancer patients with mastectomy and/or radiotherapy. A prospective study was designed to assess the accuracy of 99mTc-MIBI scintigraphy in 36 patients (mean age 49 years) with suspected recurrent breast cancer. The scintigraphic studies were correlated with radiological findings and/or with histopathology. At 10-15 min after 740MBq 99mTc-MIBI injection, standard planar images were obtained in prone lateral and anterior supine views and then single-photon emission computed tomography (SPECT) imaging was performed. A whole body imaging was also performed to demonstrate distant metastatic lesions. Totally 52 lesions were evaluated which 19 of them in 9 patients were malignant, while 33 lesions in 27 patients were benign. The sensitivity was 33%, 88% and the specificity was 96%, 93% for planar and SPECT imaging, respectively in loco-regional lesions. Overall, the sensitivity and the specificity of MIBI imaging including whole body were 89%, 81%, in other conventional radiological imaging methods were 95%, 65%, respectively. 99mTc-MIBI scintigraphy using SPECT imaging may provide useful complementary information in patients with suspected recurrence breast cancer.