None listed
Conditions
Brief summary
Multiple myeloma is a common blood cancer that affects mainly elderly people with a current trend to affect younger patients from both sexes as well. This disease mainly affects the bones and causes in late stages a permanent bone damage and fractures. This bone damage becomes worse and irreversible if there is a delay in diagnosis or treatment of myeloma occurs. To date, in Australia and worldwide convential x-rays are used to diagnose bone disease commonly associated with myeloma (about 80% of cases). However this technique is insensitive in prediction or detection of bone damage. It can be replaced by more sensitive techniques like whole body MRI, which we know little about it in conjunction with diagnosing bone disease in myeloma patients. Fortunately enough the MRI scan is now available at the Launceston General Hospital (LGH). More recently another nuclear scan technique called Sestamibi bone scan, also available at the LGH, developed to detect bone disease in cancer and may have a promising role in myeloma disease. Currently, there is no data available to compare both above techniques in early detection and diagnosis of bone disease associated with myeloma blood cancer. This trial offers a comparison between these methods in addition to other myeloma markers for early detection of bone disease. Furthermore establishing a reliable sensitive method compared to current standards for early detection of bone disease will enable clinicians to commence the appropriate treatment to prevent a devastating consequence of myeloma with bone fractures that disable many patients, who are suffering from this dreadful cancer.
Interventions
Technetium 99m-MIBI and whole body MRI scans will be studied at staging for newly diagnosed multiple myeloma and during follow-up of existing patients at every 3 monthly follow-up for a total of two years.
Technetium 99m-MIBI and whole body (magnetic resonance imaging) MRI scans will be studied at staging for newly diagnosed multiple myeloma and during follow-up of existing patients.
Technetium-99m (99mTc-sestamibi) has recently been proposed as a potential sensitive tool in early diagnosis o
Technetium 99m-MIBI and whole body MRI scans will be studied at staging for newly diagnosed multiple myeloma and during follow-up of existing patients at every 3 monthly follow-up for a total of two years. Technetium 99m-MIBI and whole body (magnetic resonance imaging) MRI scans will be studied at staging for newly diagnosed multiple myeloma and during follow-up of existing patients. Technetium-99m (99mTc-sestamibi) has recently been proposed as a potential sensitive tool in early diagnosis of bone disease in multiple myeloma, as its increased uptake in the bone marrow has been reported as indicator of myeloma activity. Whole body MRI will be performed according to the study of Baur-Melnyk et al., published in 2007. Technetium 99m-MIBI will be administered in intravenously; thereafter anterior and posterior whole body scans will be obtained, using a large field of view gamma camera equipped with a low-energy high resolution microcast collimator. A semiquantitative uptake score will be used and scintigraphic findings will be correlated with whole body MRI, clinical and laboratory data. For each patient a recent whole body MRI study will be available at the time of 99mTc-MIBI and the results of both techniques will be evaluated. Evaluation of Imaging Data All images will be assessed by two expert radiologists (more than 10 years of experience in MRI and nuclear medicine. The skeleton will be divided into 61 regions. Every region will be evaluated in a as presence of lytic lesion (yes or no) for myeloma involvement. In MRI, myeloma involvement will be determined according to the published criteria for focal or diffuse disease. Focal myeloma involvement is defined as a focal area of low signal intensity on T1-weighted spin-echo images which will be found in the bone marrow corresponding to high signal intensity on STIR images consistent with focal accumulation of myeloma cells. Diffuse infiltration is defined as diffusely reduced signal on T1-weighted spin-echo images and increased on STIR images in the bone marrow and will be graded as low, intermediate or high grade.
Sponsors
Launceston General Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult patients who are 18 years and above with confirmed diagnosis of multiple myeloma according to the Salmon and Durie/World Health Organization (WHO) criteria and attending for treatment at the Launceston General Hospital
Exclusion criteria
Patients without bone involvement
Outcome results
None listed