Cascini Giuseppe Lucio, Cuccurullo Vincenzo, Tamburrini Oscar, Mansi Luigi, Rotondo Antonio
Department of Radiological Sciences, University of Catanzaro, Catanzaro, Italy.
Nucl Med Rev Cent East Eur. 2010;13(1):32-8.
Multiple myeloma (MM) is a neoplastic monoclonal proliferation of plasma cells, mainly involving bone marrow. To properly stage and manage patients with MM the clinician needs, at first, a complete skeletal survey, being more rarely present also extra skeletal locations. Today none of the available diagnostic imaging methods is able alone to answer to all the questions regarding staging, treatment, and follow up. Continuing to be alive the role of traditional radiology, implemented information can be added by CT and MRI. Concerning nuclear medicine, bone scintigraphy is affected by its low sensitivity. Tc-99m MIBI has been proposed in staging and in follow up, with most relevant clinical information deriving from the correlation of its whole body uptake's distribution with extent and activity of the disease. The prognostic value of MIBI has also been demonstrated. PET-FDG has been proposed in MM for its ability to detect whole-body metabolic active disease, giving relevant information in staging and prognosis. First studies have demonstrated that PET-FDG is more sensitive than other imaging modalities for localizing extra medullary sites of disease.
多发性骨髓瘤（MM）是浆细胞的肿瘤性单克隆增殖，主要累及骨髓。为了正确地对MM患者进行分期和管理，临床医生首先需要进行完整的骨骼检查，骨骼外部位较少见。如今，现有的诊断成像方法都无法单独回答所有关于分期、治疗和随访的问题。传统放射学仍发挥着作用，CT和MRI可补充更多信息。关于核医学，骨闪烁显像的敏感性较低。锝-99m甲氧基异丁基异腈（Tc-99m MIBI）已被用于分期和随访，其最相关的临床信息来自于全身摄取分布与疾病范围和活性的相关性。MIBI的预后价值也已得到证实。氟代脱氧葡萄糖正电子发射断层显像（PET-FDG）已被应用于MM，因其能够检测全身代谢活跃的疾病，在分期和预后方面提供相关信息。初步研究表明，PET-FDG在定位疾病的髓外部位方面比其他成像方式更敏感。
