The clinical use of radionuclide bone marrow imaging

https://doi.org/10.1016/S0001-2998(85)80003-9Get rights and content

Bone marrow aspiration and biopsy are excellent techniques for evaluating bone marrow, but this evaluation is limited to a small part of the total blood-forming organ. With the introduction of radionuclide bone marrow imaging, a simple technique became available that overcomes marrow sampling errors by giving a total body view of functioning marrow. Furthermore, the procedure is noninvasive and provides an atraumatic method for evaluating a number of clinical problems including a discrepancy between bone marrow histology and clinical status (possible marrow sampling error), the determination of amount of active marrow after radiation and chemotherapy when further therapy is being considered, detection of sites of extramedullary hematopoiesis, location of the optimal sites for bone marrow biopsy, the diagnosis and staging of diffuse hematologic disorders, detection of metastases, the diagnosis of bone marrow infarcts in hemolytic anemias, and detecting avascular necrosis of the femoral heads. There are two major classes of bone marrow agents: (1) those that are incorporated into the erythroid precursors such as radioiron and (2) colloids that are taken up by the reticuloendothelial system (RES). Indium-111 chloride was originally considered to be an erythropoietic agent but appears to share some properties of RES labels. The best label to use is dependent on the disease being evaluated.

References (82)

  • PerezDJ et al.

    Detection of breast carcinoma metastases in bone: Relative merits of x-rays and skeletal scintigraphy: Occasional survey

    Lancet

    (1983)
  • DaCostaJL et al.

    Extramedullary hemopoiesis with multiple tumor-simulating mediastinal masses in hemoglobin E thalassemia

    Chest

    (1974)
  • FordhamEW et al.

    Radionuclide imaging of bone marrow

  • GreenbergML et al.

    Erythropoietic and reticuloendothelial function in bone marrow in dogs

    Science

    (1966)
  • NelpWB et al.

    Distribution of the erythron and the RES in the bone marrow organ

    J Nucl Med

    (1966)
  • NelpWB

    An evaluation of colloids for RES function studies

  • SmithEM

    Internal dose calculation for 99mTc

    J Nucl Med

    (1965)
  • Van DykeD et al.

    Differences in distribution of erythropoietic and reticuloendothelial marrow in hematologic disease

    Blood

    (1967)
  • EdwardsCL et al.

    Clinical bone marrow scanning with radioisotopes

    Blood

    (1964)
  • NelpWB et al.

    Distribution of the erythron and the RES in the bone marrow organ

    J Nucl Med

    (1967)
  • McIntyrePA

    Newer developments in nuclear medicine applicable to hematology

  • ChaudhuriTK et al.

    Fe-59 whole-body scanning

    J Nucl Med

    (1974)
  • AngerHO et al.

    Human bone marrow distribution shown in vivo by iron-52 and the positron scintillation camera

    Science

    (1964)
  • Van DykeD et al.

    Patterns of marrow hypertrophy and atrophy in man

    J Nucl Med

    (1965)
  • Van DykeDC et al.

    Progress in determining bone marrow distribution in vivo

  • KnospeWH et al.

    Bone marrow scanning with iron-52. Regeneration and extension of marrow after ablative doses of radiotherapy

    Cancer

    (1976)
  • GraberSE et al.

    Behavior of iron-, indium-, and iodine-labeled transferrin in the pregnant rat

  • McIntyrePA et al.

    Comparison of the metabolism of iron labeled transferrin (Fe−F) and indium labeled transferrin (In-TF) by the erythropoietic marrow

    J Nucl Med

    (1974)
  • GoodwinDA et al.

    In-111-labeled transferrin for the detection of tumors

    Radiology

    (1971)
  • HarrisJW et al.
  • StaubRT et al.

    In-111-chloride distribution and kinetics in hematologic disease

    J Nucl Med

    (1973)
  • WochnerRD et al.

    A new method for estimation of plasma volume with the use of the distribution space of indium-113m-transferrin

    J Lab Clin Med

    (1970)
  • FarrerPA et al.

    Further observations of the use of In-111-transferrin for the visualization of bone marrow in man

    J Nucl Med

    (1973)
  • McNeilBJ et al.

    Use of indium chloride scintigraphy in patients with myelofibrosis

    J Nucl Med

    (1974)
  • McNeilBJ et al.

    Indium chloride scintigraphy: An index of severity in patients with aplastic anemia

    Br J Haematol

    (1976)
  • HornNL et al.

    Evaluation of aplastic anemia with indium chloride In-111 scanning

    Arch Intern Med

    (1980)
  • SayleBA et al.

    Bone marrow imaging with indium-111 chloride in aplastic anemia and myelofibrosis: Concise communication

    J Nucl Med

    (1982)
  • TouyaJJ et al.

    Patterns of bone marrow scintigraphy

  • MerrickMV et al.

    A comparison of In-111 with Fe-52 and Tc-99m-sulfur colloid for bone marrow scanning

    J Nucl Med

    (1974)
  • McIntyrePA et al.

    The blood

  • SykesMP et al.

    Long-term effects of therapeutic irradiation upon bone marrow

    Cancer

    (1964)
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