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Assessment of whole body MRI and sestamibi technetium-99m bone marrow scan in prediction of multiple myeloma disease progression and outcome: a prospective comparative study

Citation

Khalafallah, AA and Snarski, A and Heng, R and Hughes, R and Renu, S and Arm, J and Dutchke, R and Robertson, IK and To, LB, Assessment of whole body MRI and sestamibi technetium-99m bone marrow scan in prediction of multiple myeloma disease progression and outcome: a prospective comparative study, BMJ Open, 3, (1) Article A27. ISSN 2044-6055 (2013) [Refereed Article]


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Licensed under Creative Commons Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0) http://creativecommons.org/licenses/by-nc/2.0/

DOI: doi:10.1136/bmjopen-2012-002025

Abstract

Objectives: This study aims primarily to determine whether whole body MRI(WB-MRI)and Sestamibi Technetium-99m-bone marrow (MIBI) scans in the same patients produce the same estimate of disease load and location, and secondly, to study possible association between the bone disease detected by these scans and the effect on disease outcome and survival. Bone disease occurs in about 90% of multiple myeloma (MM) patients. There are no data comparing the new diagnostic modalities with WB-MRI and MIBI in MM.

Design: A prospective comparative study between WB-MRI and MIBI scans in assessing bone disease and outcome of MM.

Participants and Methods: Sixty-two consecutive patients with confirmed MM underwent simultaneous WB-MRI (both axial T1 and turbo spin echo short tau inversion recovery (STIR)) and MIBI scans at a single institution from January 2010 to January 2011, and their survival status was determined in January 2012. The median age was 62 years (range 37-88) with a male-to-female ratio of 33 : 29. RESULTS: In vertebrae and long bones, MRI scan detected more disease compared with MIBI scan (p<0.001) but there was less difference in the skull (p=0.09). In the ribcage, the MIBI scan detected more lytic lesions of the ribs compared with MRI scan (p<0.001). Thirteen of the 62 patients died during the 24-month follow-up. Increased disease detected in all bones by both scans was associated with increased mortality risk (MIBI p=0.001; MRI-STIR p=0.044; but not MRI-T1 p=0.44). In all combined bone groups, the mean MIBI scan results provided a better prediction of mortality than MRI scan over the follow-up period (MRI-T1 vs MIBI p=0.019; MRI-STIR vs MIBI p=0.047).

Conclusions: Although WB-MRI detected more MM bone disease, MIBI scan predicted overall disease outcome and mortality better than MRI scan. Further studies to define optimum use of these imaging techniques are warranted.

Item Details

Item Type:Refereed Article
Keywords:Nuclear Medicine, Radiology & Imaging, Qualitative Research
Research Division:Medical and Health Sciences
Research Group:Oncology and Carcinogenesis
Research Field:Cancer Diagnosis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cancer and Related Disorders
Author:Khalafallah, AA (Professor Alhossain Khalafallah)
Author:Robertson, IK (Dr Iain Robertson)
ID Code:82417
Year Published:2013
Web of Science® Times Cited:1
Deposited By:Health Sciences A
Deposited On:2013-02-01
Last Modified:2017-11-06
Downloads:471 View Download Statistics

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