Radionuclide imaging of bone marrow disorders

Abstract

Noninvasive imaging techniques have been used in the past for visualization the functional activity of the bone marrow compartment. Imaging with radiolabelled compounds may allow different bone marrow disorders to be distinguished. These imaging techniques, almost all of which use radionuclide-labelled tracers, such as 99mTc-nanocolloid, 99mTc-sulphur colloid, 111In-chloride, and radiolabelled white blood cells, have been used in nuclear medicine for several decades. With these techniques three separate compartments can be recognized including the reticuloendothelial system, the erythroid compartment and the myeloid compartment. Recent developments in research and the clinical use of PET tracers have made possible the analysis of additional properties such as cellular metabolism and proliferative activity, using 18F-FDG and 18F-FLT. These tracers may lead to better quantification and targeting of different cell systems in the bone marrow. In this review the imaging of different bone marrow targets with radionuclides including PET tracers in various bone marrow diseases are discussed.

Estimating the whole bone-marrow asset in humans by a computational approach to integrated PET/CT imaging

“…The recognition of the two different marrow types is founded on the concept-documented both by pathology [22] and by imaging studies [2,9,10]-that vertebral bodies are mainly occupied by red BM. Actually, our approach showed that FDG uptake in this bone region is higher than in the rest of the IBV and displays a gaussian distribution.…”

“…In the present study, we propose a new approach to this issue exploiting the advantages of hybrid PET/CT technology. FDG imaging has been already used to document BM infiltration by cancer [2,[10][11][12][13] and to monitor the haematopoietic response to chemo-and radiotherapy in specific bone regions [14]. The aim of our methods was to extend this clinically validated tool to provide a first description of the extension and distribution of the BM throughout the whole skeleton of living humans.…”

“…In recent decades, this evaluation has been attempted using radionuclidelabelled tracers targeting the reticuloendothelial system [2,3], as well as erythropoietic [4] or granulopoietic cells [5]. These techniques offer the advantage of directly interrogating specific BM functions, but they cannot estimate BM volume because of intrinsic limitations in both tracer kinetics and the physics of single photon detection.…”

Assessment of bone marrow inflammation in patients with myelofibrosis: an 18F-fluorodeoxyglucose PET/CT study

“…Scintigraphic techniques including 111 In-chloride and 99m Tc-labelled colloids can be used to visualize different physiological aspects of the bone marrow activity [22][23][24], but do not target the myeloproliferation or the state of chronic inflammation within the bone marrow compartment. 18 F-FDG PET/ CT is an established imaging modality for detection of various haematological neoplasms [23,25], and has become a useful tool for response assessment in haematooncology [26].…”

Bone Scintigraphy Scanning Safety and Necessity for Silent and Multifocal Osteonecrosis in Sickle Cell Disease

“…In a multicenter study of symptomatic multifocal osteonecrosis, various authors suggested that a total body BSc may be the most cost-effective means of screening for multifocal involvement [26], when the multifocal lesions are not recognizable on plain radiography before localized by BSc technology [27]. The SCD osteonecrosis could be completely clinically silent [28].…”