Multimodality Molecular Imaging in Arthropathy Associated with Multiple Myeloma

Ludmila Santiago Almeida; Stephan Pinheiro Macedo de Souza; Fernando Vieira Pericole de Souza; Fabiano Reis; Celso Dario Ramos

doi:10.4103/ijnm.ijnm_205_21

Multimodality Molecular Imaging in Arthropathy Associated with Multiple Myeloma

Indian J Nucl Med. 2022 Jul-Sep;37(3):290-292. doi: 10.4103/ijnm.ijnm_205_21. Epub 2022 Nov 2.

Authors

Ludmila Santiago Almeida¹, Stephan Pinheiro Macedo de Souza¹, Fernando Vieira Pericole de Souza², Fabiano Reis³, Celso Dario Ramos¹

Affiliations

¹ Department of Radiology, Division of Nuclear Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.
² Department of Internal Medicine, Division of Hematology, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.
³ Department of Radiology, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil.

Abstract

We report a patient with multiple myeloma (MM) and polyarthritis of large joints. During the staging of the disease, bone marrow diffusely involved by MM was clearly demonstrated by 99mTc-2-methoxy-isobutyl-isonitrile (MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) but not by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT images. On the other hand, a very intense uptake of 18F-FDG was detected in periarticular tissues of multiple joints, with nonabnormal 99mTc-MIBI accumulation. Rheumatology tests were negative. A subsequent bone scintigraphy demonstrated radiolabeled bisphosphonate accumulation in periarticular tissues, suggesting amyloid arthropathy.

Keywords: 18F-fluorodeoxyglucose; 99mTc-methylene diphosphonate; 99mTc-sestamibi; arthropathy; light-chain amyloidosis; multiple myeloma.