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Whole-body 18F-FDG-PET also detects diffuse and/or focal increased uptake of radionuclide in myeloma patients. In a study of 66 patients, a positive scan was obtained in all 16 untreated patients with active myeloma, including four (25%) who had a negative radiographic bone survey.106 Extramedullary plasmacy-toma was detected and verified by histologic examination. Importantly, tests for MGUS were negative, and new lesions were found in relapsed patients. A comparative study with Tc 99m MIBI and FDG-PET suggests the former reflects more the extent of disease, while the latter is more sensitive to active proliferative lesions.119 The validity of FDG-PET has yet to be determined.

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