Summary
Aplastic anaemia affects the entire bone marrow. Current methods of assessment of bone marrow function, like bone marrow biopsy or peripheral blood examination are either invasive or inadequate and cannot be expected to represent fully the changes in the entire bone marrow tissue. This prospective study was undertaken to develop and standardise a new Nuclear Medicine technique called ‘Dynamic Bone marrow Imaging’.
Eleven patients and ten controls were studied. Serial images of the pelvis were obtained in frame mode following intravenous injection of 185–370 mBq of 99mTc S. Colloid, and an index, called the Bone Marrow Uptake Index (P) was calculated by taking into consideration the time activity curve obtained over the iliac crest. This was followed by static imaging of the entire bone marrow in all cases.
It was possible to obtain excellent information regarding topographic distribution of bone marrow as well as detect early changes in bone marrow function following treatment. An attempt was also made to correlate bone marrow cellularity as obtained by bone marrow biopsy with the results of dynamic bone marrow scintigraphy. On the basis of the encouraging results obtained in the present study, the authors feel that dynamic bone marrow imaging is an excellent technique for the objective evaluation of bone marrow in aplastic anaemia.
Aplastic anaemia affects the entire bone marrow tissue. Although much progress has been made in the management of this disease, many aspects of it await better understanding. There is almost total lack of knowledge regarding the distribution of functioning marrow in various phases of aplastic anaemia, such as in relapse and remission [1,2,6,10,20]. Current methods of assessment of marrow function rely mainly on bone marrow biopsy and peripheral blood examination. Bone marrow biopsy is invasive and cannot be expected to represent fully the changes in the entire tissue [4]. Changes in peripheral blood picture lag behind the changes in the bone marrow. Thus, there is a need for an investigation which is safe, simple, sensitive, non invasive and capable of assessing the global function of bone marrow.
Radio-nuclide imaging of bone marrow requires labelling of one or more components of this widely dispersed tissue. The reticuloendothelial and erythropoietic components can be labelled with radio-colloids and radio-iron respectively [3, 5, 8, 9, 12, 13, 15, 16, 17, 19]. Experimental studies have shown that the reticuloendothelial and erythropoietic elements are invariably found together in the marrow and have similar distribution [7, 18].
This report is based on a prospective study of bone marrow function in patients with aplastic anaemia, using 99mTc. Sulphur colloid.
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References
Boggs DR, Boggs SS: The pathogenesis of Aplastic anaemia. Blood 48: 71–76, 1976
Dacie JV, Lewis SM: Practical Haematology (4th Edition) Churchill, London, 1968
Edward LC, Andrews GA, Sitterson BW, et al.: Clinical bone marrow scanning with radio isotopes. Blood 23: 741–756
Firsch B, Lewis SM: The bone marrow in aplastic anaemia: Diagnostic and prognostic features. J Clin Pathol 27: 231–241, 1974
Fordham EW, Amjad Ali: Radio nuclide imaging of the bone marrow. Semin Hematol 18: 222–239, 1981
Gale RP, Champlin RE, Feig SA, et al.: Aplastic anaemia: Biology and treatment. Ann Intern Med 95: 477–494, 1981
Greenberg ML, Atkins HL, Schiffer LM: Erythropoietic and reticuloendothelial fucntion in bone marrow in dogs. Science 152: 526 - 528, 1966
Henry RE, Fletcher JW, George EA, et al.: Bone marrow Tc.99m Sulphur Colloid distribution and marrow cellularity. Am J Med Sei 270: 419–424, 1975
Knisely RM: Marrow studies with radio colloids. Semin Nucl Med 2: 71–85, 1972
Kochupillai V, Sharma S, Sundaram KR: Anabolic steroids in aplastic anaemia Indian. J Med Res 80: 174–179, 1984
Kochupillai V, Sharma S, Francis S, et al.: Bone marrow reconstitution following human fetal liver infusion (FLI) in sixteen severe aplastic anaemia patients In Fetal Liver Transplantation, Ed. Gale RP and Touraine JL. Alan R Liss, Inc, New York, 1985, p 251–265
Lillien DL, Berger HG, Andorson DP, et al.: Indium-111 Chloride: A new agent for bone marrow imaging. J Nucl Med 14: 184–186, 1973
McNeil BJ, Rappaport JM, Nattan DG: Indium chloride scintigraphy and index of severity in patients with aplastic anaemia. Br J Haematol 34: 599–604, 1976
McNeil BJ, Holman BL, Button LN, et al.: Use of Indium Chloride scintigraphy in patients of myelofibrosis. J Nucl Med 15: 647–651, 1974
Najean Y, Le Danvic M, Le Mercier N, et al.: Significance of bone marrow scintigraphy in aplastic anaemia- Concise communication. J Nucl Med 21: 213–218, 1980
Neal LH, Bennett LR, Marciano RT: Evaluation of aplastic anaemia with In-111 Chloride. Arch Intern Med 140: 1299–1303, 1980
Nelp WB, Larson SM, Lewis RJ: Disribution of the erythron and RES in the bone marrow organ. J Nucl Med 8: 430 - 434, 1967
Sayle BA, Helmer RE, Birdsong BA, et al.: Bone marrow imaging with In-111 Chloride in aplastic anaemia and myelofibrosis — Concise communication. J Nucl Med 23: 121–125, 1982
Schreiner DP: Reticuloendothelial scan in disorders involving the bone marrow. J Nucl Med 15: 1158–1162, 1974
Vincent PC, deGruchy GC: Complications and treatment of acquired aplastic anaemia. Br J Haematol 13: 977–999, 1967
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© 1987 Martinus Nijhoff Publishers, Dordrecht
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Padhy, A.K., Garg, A., Kochupillai, V., Gopinath, P.G., Basu, A.K. (1987). Marrow uptake index (MUI): A quantitative scintigraphic study of bone marrow in aplastic anaemia. In: Touraine, JL., Gale, R.P., Kochupillai, V. (eds) Fetal liver transplantation. Developments in Hematology and Immunology, vol 18. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-3365-1_16
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DOI: https://doi.org/10.1007/978-94-009-3365-1_16
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