technetium-tc-99m-sulfur-colloid and indium-trichloride

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.

Topics: Anemia, Aplastic; Anemia, Hemolytic; Anemia, Sickle Cell; Bone Marrow; Bone Marrow Diseases; Bone Neoplasms; Erythropoiesis; Femur Head Necrosis; Gold Colloid, Radioactive; Hematopoiesis; Humans; Indium; Iron Radioisotopes; Leukemia; Lymphoma; Mononuclear Phagocyte System; Polycythemia; Primary Myelofibrosis; Radioisotopes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

We aimed to compare the accuracy of fluorodeoxyglucose positron emission tomography (FDG-PET) with technetium-99m sulfur colloid (111)indium-labeled white blood cell scintigraphy (TcSC-Ind BM/WBC) in diagnosis of periprosthetic infection. Eighty-nine patients with 92 painful hip prostheses were recruited prospectively and given the option of undergoing either combined FDG-PET and TcSC-Ind BM/WBC or FDG-PET only. FDG-PET correctly diagnosed 20 of the 21 infected cases (sensitivity, 95.2%) and ruled out infection in 66 of the 71 aseptic hips (specificity, 93%) corresponding to a positive predictive value of 80% (20/25) and a negative predictive value of 98.5% (66/67). TcSC-Ind BM/WBC correctly identified 5 of the 10 infected cases (sensitivity, 50%) and 39 of 41 aseptic cases (specificity, 95.1%) corresponding to a positive and negative predictive values of 41.7% (5/12 cases) and 88.6% (39/44 cases), respectively. Based on these preliminary results, FDG-PET appears to be a promising diagnostic tool for distinguishing septic from aseptic painful hip prostheses.

Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Biomarkers; Equipment Failure Analysis; Humans; Indium; Leukocytes; Middle Aged; Pain Measurement; Positron-Emission Tomography; Prospective Studies; Prosthesis-Related Infections; Radiopharmaceuticals; Reoperation; Sensitivity and Specificity; Technetium Tc 99m Sulfur Colloid

Symptoms suggesting gastroparesis in patients without gastric outlet obstruction are very common but their relation to an objective delay of gastric emptying has been poorly investigated. A dual isotopic technique was used to evaluate patients with non-obstructive dyspepsia (idiopathic and secondary) (part 1) and to assess the effects of a new gastrokinetic agent: cisapride, on gastric emptying in such patients (part 2). Sixty patients with postprandial dyspeptic symptoms (vomiting, nausea, gastric bloating or full feeling) and without lesions at upper endoscopy were studied. They were distributed into three groups: idiopathic dyspepsia (n = 31), postvagotomy dyspepsia (n = 16) and dyspepsia secondary to medical disorders (n = 13). All patients ingested the same ordinary meal; 99mTc sulphur colloid tagged egg white was the solid phase marker and 111In chloride was the liquid phase marker. In part 1, evaluation of gastric emptying in the first 50 patients shows a delay of gastric emptying rate of solids and liquids as compared with controls. Striking differences separate the three groups of patients, however, percentages of delayed gastric emptying rate of solids and or liquids averaged 90% in postvagotomy or secondary dyspepsia groups whereas it was 44% in idiopathic dyspepsia group. Moreover, liquid emptying rate was often the only one impaired in idiopathic dyspepsia, and in 12 of the 27 patients of this group the faster emptying rate of liquids as compared with that of solids (always found in normal subjects), could not be evidenced. In part 2, 10 patients entered a double blind cross over study of cisapride (8 mg intravenously). A significant increase of solid (p<0.01) and liquid (p<0.05) emptying rates was found in patients with initial gastric emptying delay. This study emphasises the importance of an objective evaluation of gastric emptying in the presence of symptoms of gastric stasis and suggests that specific local acting therapy may be useful in patients with identified abnormal gastric emptying.

Topics: Adult; Aged; Cisapride; Clinical Trials as Topic; Double-Blind Method; Drug Evaluation; Dyspepsia; Female; Gastric Emptying; Humans; Indium; Male; Middle Aged; Piperidines; Technetium Tc 99m Sulfur Colloid; Time Factors; Vagotomy

The scintigraphy of the bone marrow can supply information for its distribution in the body and for its functional state as well. The purpose of the study is to assess the efficacy of the scintigraphic imaging of the bone marrow by means of radiopharmaceutical drugs--99mTc-sulfur colloid for imaging the monocytic macrophagal system and 111In-chloride for imaging of erythroid cells--and to determine its characteristics in some hematologic diseases. 72 patients with hematologic diseases and 10 healthy controls were examined. The results lead to the conclusion that bone marrow scintigraphy is a useful method which helps the physician in the diagnosis of hematologic diseases, the determination of the stage of the disease, the assessment of the efficacy of the treatment applied and in all cases of discrepancy between the bone marrow histology and the clinical status of the patient.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Marrow; Female; Hematologic Diseases; Humans; Indium; Indium Radioisotopes; Macrophages; Male; Middle Aged; Monocytes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Aged; Bone and Bones; Bone Marrow; Female; Humans; Indium; Indium Radioisotopes; Primary Myelofibrosis; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Bone Marrow; Hematologic Diseases; Humans; Indium; Indium Radioisotopes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Twenty-three patients with hepatic cirrhosis and focal defects on Tc-99m sulfur colloid (SC) scintigrams were restudied with In-111 chloride to determine if indium localization in the focal defect is indicative of a hepatoma. Seven of eight patients with proven hepatomas had positive studies; however, six of 15 patients without hepatomas also had studies interpreted as positive. Thus, In-111 chloride is highly sensitive for the detection of hepatomas, and a negative indium study would militate against this diagnosis. The high false-positive rate found may be due to technical factors rather than a lack of specificity of localization; the experience of others seems to support this impression. At present, In-111 chloride scintigraphy for focal hepatic defects appears to be useful in ruling out hepatoma.

Topics: Carcinoma, Hepatocellular; False Positive Reactions; Humans; Indium; Liver; Liver Cirrhosis; Liver Neoplasms; Male; Middle Aged; Radioisotopes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Using combined Tc-99m sulfur colloid and In-113m chloride eluate imaging, studies from 32 patients with proven amebic liver abscess were analyzed. The results revealed good perfusion of the amebic lesion in three, poor perfusion in 11, and absent perfusion in 18. These results appear to depend on abscess size and age. Images with In-113m seem to be better than those with Tc-99m sulfur colloid in depicting amebic liver abscess during antiamebic therapy. Overall, the In-113m images provide more precise information concerning abscess size and shape.

Topics: Acute Disease; Biopsy, Needle; Humans; Indium; Liver Abscess, Amebic; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Humans; Indium; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Radioisotopes; Radionuclide Imaging; Spleen; Splenic Neoplasms; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

A patient with postpolycythemic myeloid metaplasia developed an enlarging abdominal mass documented on TCT scanning. To distinguish between lymphoma and extramedullary hematopoiesis, marrow elements were imaged with indium-111 chloride and technetium-99m sulfur colloid. Because the mass failed to accumulate either tracer, a presumptive diagnosis of lymphoma was made and exploratory surgery was performed. The excised mass was found to consist of enlarged lymph nodes containing extramedullary hematopoiesis. Caution should be exercised in the use of In-111 or Tc-99m SC bone-marrow scans to diagnose sites of extramedullary hematopoiesis.

Topics: Bone Marrow; Diagnostic Errors; Hematopoiesis; Humans; Indium; Lymphoma; Male; Middle Aged; Primary Myelofibrosis; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Bone marrow scintigraphy was performed in 29 patients with hemopoietic depletion states of various etiology. Two tracers were used for visualization of the marrow: 99mTc-sulphur-colloid and 111InCl3, some patients being examined by both indicators. 111InCl3 is bound on transferrin and is adsorbed on the surface of reticulocytes and erythroblasts). The scintillation camera PHO GAMMA SEARLE IV fitted with moving table and computer CLINCOM was used, so that whole body images were obtained. The comparison of all scans and marrow puncture smears was done. In patients with aplastic anemia with both hyperplastic or hypoplastic marrow good correlation of bone marrow scans and sternal puncture smears was found. In several cases the scintigraphic examination helped to establish a diagnosis of marrow depletion state. A peculiar disadvantage of the imaging method with either 99mTc-sulphur-colloid or 111InCl3 is that it shows the disorders in erythropoietic and reticuloendothelial cells, whereas the defects in myelopoietic cell series and platelet precursors are not provable. According to literature data, great attention is paid to the prognostic value of scintigraphic examination in aplastic anemia.

Topics: Adult; Anemia, Aplastic; Bone Marrow; Bone Marrow Diseases; Humans; Indium; Male; Middle Aged; Primary Myelofibrosis; Radioisotopes; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid