Recent advances in bone marrow scanning

Abstract

Interest in bone marrow scanning has been renewed as the result of the development of radiopharmaceuticals for evaluating specific aspects of bone marrow anatomy, physiology and pathology. This article provides a brief review of bone marrow structure, blood flow and function essential to the understanding of basic principles of bone marrow radionuclide imaging. The prospects and limitations of imaging haematopoietic bone marrow in man using indium 111 chloride, technetium-99m (99mTc)-labelled microcolloid or 99mTc-labelled monoclonal antigranulocytic and antimyelocytic antibodies are discussed in more detail. The technical aspects of bone marrow scintigraphy are presented. Results of more recent studies evaluating bone marrow scanning in circulatory, inflammatory and in systemic haematological disorders are summarized. Special attention is paid to the concept of bone marrow micrometastases and its implications for the follow-up of patients with malignant tumours. Recent results suggest that immunoscintigraphy of bone marrow may provide a novel and sensitive approach for establishing the presence and extent of bone marrow infiltration.

Bone Marrow (Reticuloendothelial System) Scintigraphy for Haematological Follow-Up of Radiochemotherapy-Treated Patients

“…Since bone marrow' reacts as a functional unit, it can be best evaluated by marrow biopsy, especially diagnostic imaging-guided biopsy [14]. However, our observations (i.e.…”

“…Recent results indicate that immunoscintigraphy with monoclonal antigranulocytic antibodies provides a highly specific and sensitive approach for the assessment of the haemopoietic status of the bone marrow [14], As the up take of these antibodies by the liver and spleen is limited, the improved image quality diminishes the interpretation problems stemming from superposition. This method has two disadvantages, however, the considerable price and the undesirable patient immunisation; the latter may re sult in risk on subsequent administration.…”

Rhenium 188–labeled anti-CD66 (a, b, c, e) monoclonal antibody to intensify the conditioning regimen prior to stem cell transplantation for patients with high-risk acute myeloid leukemia or myelodysplastic syndrome: results of a phase I-II study

“…In these diagnostic studies no relevant binding to normal tissues other than bone marrow has been observed. 25,26 Thanks to the large number of target sites and its high affinity, the antibody rapidly and quantitatively accumulates in the marrow, thus ensuring a potent crossfire effect. 24,25,33,49,50 We felt that these advantageous properties outweighed potential disadvantages such as a lack of binding to myeloid leukaemic blasts.…”

“…The anti-CD66 antibody (antigranulocyte, anti-nonspecific crossreacting antigen 95, BW 250/183) is well characterized with respect to biokinetic data and clinical application in bone marrow scintigraphy and localization of infections. [25][26][27] The CD66 antigen is expressed at a high density (2 ϫ 10 5 molecules per cell) on normal myelopoietic cells from the promyelocyte onward but not on AML blasts. [28][29][30][31] Aberrant expression is found on a significant fraction of CD10 ϩ acute lymphoblastic leukemia (ALL) blasts.…”

Radioimmunotherapy-based conditioning for hematopoietic cell transplantation in children with malignant and nonmalignant diseases

“…23,27 The anti-CD66 antibody (antigranulocyte, anti-nonspecific cross-reacting antigen 95; BW 250/183) is well characterized with respect to biokinetic data and clinical application in bone marrow (BM) scintigraphy. [28][29][30] Yttrium-90 ( 90 Y) is a ␤-particle emitter with a high energy (2.3 MeV), a maximum range of the ␤ particles of 11 mm, and a half-life of 2.7 days. 31 90 Y administration does not require isolation of patients because it does not emit ␥ radiation.…”