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Bone-Marrow Imaging with Indium-111 Chloride in Aplastic Anemia and Myelofibrosis: Concise Communication

University of Texas Medical Branch, Galveston, Texas

Correspondence: For reprints contact: Bettye A. Sayle, MD, Div. of Nuclear Medicine, Dept. of Radiology, Univ. of Texas Medical Branch, Galveston, TX 77550.

ABSTRACT

Twenty-nine patients with aplastic anemia and 11 patients with myelofibrosis were evaluated with Indium-111 chloride bone-marrow imaging, ferrokinetics, and bone-marrow core biopsies. There was good correlation between the erythrocyte cellularity of the marrow and the In-111 bone-marrow scan grades in most patients. In some, the overall scan grade tended to underestimate the erythroid elements because the core biopsy had been taken from the area of the greatest radionuclide concentration on the scan. In patients with aplastic anemia, there was good correlation between the plasma iron clearance t_1/2 and the scan grade. Less agreement was found in the comparison between the Fe-59 sacral and organ counts and the red-cell iron utilization. In patients with myelofibrosis, there was poor correlation between the surface counts over the sacrum and the red-cell iron utilization. Plasma iron clearances were abnormally short and were unrelated to the transferrin saturation levels. Eighteen patients were studied several times to evaluate their responses to steroid therapy. In all, there was good correlation between the bone-marrow imaging, the erythrocyte cellularity, ferrokinetics, and the patient's response to therapy. Indium-111 bone-marrow imaging is useful both in evaluating marrow erythroid activity and in following the response to therapy in patients with these diseases.