Radiographic and radionuclide imaging in multiple myeloma: the role of gallium scintigraphy: concise communication.

Eighteen patients with multiple myeloma were studied using radiographs of the skeletal system, technetium phosphate bone scans, and gallium-67 scintigraphy. A total of 94 sites were used as the basis for comparison in these 18 patients. Radiographic sensitivity on a patient basis was 94%, and was 82% on a site basis. Bone scans were positive in 78% of patients and in 46% of sites. Gallium scans were positive in 56% of patients and 40% of sites. In five of the 18 patients, gallium scans showed activity in abnormal sites with a greater lesion-to-nonlesion ratio than did the bone scan. In this subgroup of patients, the disease was fulminant, and all died within 3 mo of their study. The finding of high gallium uptake in osseous sites that are normal or only slightly abnormal on bone scan has served to identify a subgroup of patients with rapidly progressive disease who may benefit from alternative treatment modalities such as radiation therapy.