technetium-tc-99m-exametazime and Bone-Marrow-Diseases

111In or 99mTc-HMPAO labeled leukocyte scintigraphy has been shown to be useful in detection and diagnosis of infections and inflammatory lesions. Results from multiple retrospective series indicate that leukocyte scintigraphy achieves sensitivity and specificity of near 90% in abdominal abscess detection. 99mTc-HMPAO labeled leukocyte scintigraphy is now an accepted technique in the assessment of patients with inflammatory bowel disease and the diagnostic value of early 99mTc-HMPAO labeled leukocyte images has been discussed. It is known that 99mTc-HMPAO labeled leukocytes migrate to a large extent to the bone marrow. 99mTc-HMPAO labeled leukocytes may prove to be a practical agent for bone marrow imaging. In this report, definition, classification and pathological consideration of inflammation, and history, diagnostic efficacy and consideration for clinical application of inflammation scintigraphy are reviewed.

Topics: Bone Marrow Diseases; Contrast Media; Humans; Indium; Infections; Inflammation; Isotope Labeling; Leukocytes; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Exametazime

The current study was initiated to define whether Tc-99m leukocyte imaging, compared to In-111 chloride imaging, could provide additional information on the hematopoietic activity of the bone marrow in diffuse hematologic disorders. A total of 11 patients with hematologic disorders were studied both with Tc-99m leukocytes and In-111 chloride. One patient with myelofibrosis showed disparate tracer distribution in the bone marrow between the two; Tc-99m leukocyte uptake in the central marrow was highly decreased, whereas In-111 chloride showed expanded marrow. The disparate results of granuloid hypoplasia and erythroid hyperplasia obtained by bone marrow biopsy and aspiration in this patient were thought to give an explanation for the radionuclide findings. The remaining 10 patients showed similar tracer distribution in the marrow, and the observation of hematopoietic cellularity confirmed by bone marrow biopsy and aspiration correlated well with the radionuclide findings. These results demonstrate that Tc-99m leukocytes may be a potential imaging agent for evaluating hematopoietic activity in the bone marrow, in particular granulopoietic activity.

Topics: Adult; Anemia; Bone Marrow; Bone Marrow Diseases; Hematopoiesis; Humans; Indium; Indium Radioisotopes; Leukocytes; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime