Tc 99m MIBI

Scanning with Tc 99m 2-methoxyisobutylisonitrile, a lipophilic, cationic agent accumulated in metaboli-cally active tissues and extruded from the cells through MDR-1 p-glycoprotein, has recently been shown to have a higher sensitivity. Diffuse bone marrow uptake or focal enhanced bone lesions may be detected. The latter lesions are concordant with radiographic bone lesions in about 70% of the cases. It was suggested that the lesions detected by Tc 99m MIBI represented active disease sites, and the intensity of radionuclide uptake correlated with the disease activity, as reflected by high levels of disease markers, such as ^-microglobulin and CRP.116-118 Its clinical utility is still experimental.

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