Whole Body MIBI Myeloma Scan

Author: Dr Dee Nandurkar*

What are the prerequisites for having a whole body MIBI myeloma scan done?

As the scan involves an injection of radioactivity, it is not advisable in pregnant females.

What are the absolute contraindications for a whole body MIBI myeloma scan?

This study may not be suitable for pregnant women. The benefit versus risk should be discussed with the nuclear medicine specialist.

Women who are breastfeeding and people who are the primary or sole carer for small children may need to make special preparations after the test to stop breastfeeding for a short time and to avoid close contact with young children due to the small amount of radioactivity released for a while after the test. Patients should discuss this with their referring doctor or the nuclear medicine practice where they will have the test for details. See nuclear medicine for further information about the precautions to take with nuclear medicine studies for breastfeeding patients and those in close contact with children.

What are the relative contraindications for a whole body MIBI myeloma scan?

Most scanners will have a weight limit ranging from 160-200 kilograms.

What are the adverse effects of a whole body MIBI myeloma scan?

Generally there are no adverse reactions, but on rare occasion the patient may experience a metallic taste, tingling, flushing, nausea, erythema, diffuse rash, or headache. These effects are short-lived.

Are there alternative imaging tests, interventions or surgical procedures to a whole body MIBI myeloma scan?

Conventional X-rays will detect disease involvement in 75-95% of cases with 80% sensitivity. However, radiography is unable to discriminate between active osteolytic areas and healed lesions.

Skeletal lesions in myeloma are rarely osteoblastic (bone forming or dense on plain X-rays or CT scanning) and hence radiopharmaceuticals such as technetium-99m-disphosphonate (bone scans) do not demonstrate an avid uptake. Reported sensitivity for multiple myeloma of routine bone scanning ranges from 40% to 60%.

MRI is superior to plain X-rays, but it is impractical for routine whole body survey, due to long imaging time and costs. Substitution of X-rays by MRI limited to the spine and pelvis would cause under-staging by 10%.

PET imaging is often complementary, but is not a substitute for a MIBI scan for detection of myeloma.

*The author has no conflict of interest with this topic.

Page last modified on 26/7/2017.