Nuclear medicine in myeloma: the state of the science and emerging trends.

We present the different imaging modalities in relation to myeloma, ranging from the time tested X-ray radiography to the newer promising methods of fluorine-18 fluorodesoxyglucose-positron emission tomography ((18)F-FDG-PET) and technetium-99m methoxy isobutyl isonitrite ((99m)Tc-MIBI) scintigraphy. A small discussion regarding newer methods such as fluoride-18 positron emission tomography ((18)F-PET), fluorine-18-fluoro-deoxy-L-thymidine positron emission tomography ((18)F-FLT PET), carbon-11 methionine positron emission tomography ((11)C-methionine PET) and the tritiated thymidine labeling index is also included. They have different mechanisms of tracer uptake enabling the visualization of the spectrum of the disease manifestations ranging from osteoblastic to osteolytic lesions, and also the study of the metabolic status, proliferative and protein activity, in skeletal and in extra-skeletal sites.