BONE MARROW STUDY
Radiology Associates of Clearwater
Overview
Functioning bone marrow consists of several cell lines which tend to be distributed in
parallel. The Bone Marrow Study performed with radiocolloid demonstrates the
distribution of functioning bone marrow within the skeleton by imaging one
component of the bone marrow, the intravascular mononuclear phagocyte system.
Indications
Evaluation of regional bone marrow abnormalities in general (1-3).
Selection of bone marrow biopsy sites (4).
Diagnosis of osteomyelitis in conjunction with In-111-white blood cell (In-111-WBC)
imaging (5-7).
Examination Time
1 hour.
Patient Preparation
None.
Equipment & Energy Windows
Gamma camera: Large field of view.
Collimator: Low energy, high resolution, parallel hole.
Energy window: 20% window centered at 140 keV.
Radiopharmaceutical, Dose, & Technique of Administration
Radiopharmaceutical (8-10): Tc-99m-sulfur colloid.
Filtered with 0.22 micron millipore filter.
* Tc-99m-albumin colloid may be used.
Dose: 15 mCi (555 MBq).
10mCi filtered if used in conjunction with 111-In-WBC scanning.
Technique of administration: Standard intravenous injection.
Patient Position & Imaging Field
Patient position: Supine
Imaging field: Entire skeleton. Areas of interest for infection imaging.
Acquisition Protocol
Wait 15 minutes following injection of the radiopharmaceutical before imaging.
Imaging may be performed with either multiple spot images or whole body images.
For spot images:
1.
Image the head and torso in the ANT and POST projections; and the arms
and legs in the ANT projection.
2.
Acquire each image for approximately 2 minutes.
For whole body imaging:
1.
Image the entire body in the ANT projection and the head and torso in the
POST projection (Acquire spot images of the arms if necessary.).
2.
Allot approximately 25 minutes to the ANT acquisition and 15 minutes to the
POST acquisition.
Data Processing
None.
Optional Maneuvers
Bone marrow imaging may be performed in conjunction with In-111-WBC studies
for osteomyelitis to increase the specificity of the test (5-7):
1.
When the patient returns for In-111-WBC imaging, inject filtered 99m-TcSCOL and wait 15 minutes. Then acquire dual isotope images of the
selected area.
a) Acquire in 3 windows, 140KeV, 172KeV, 247Kev
Alternative radiopharmaceutical: Bone marrow imaging may be performed with
In-111 chloride (11-13).
Principle Radiation Emission Data - Tc-99m (14)
Physical half-life = 6.01 hours.
Radiation
Gamma-2
Mean % per disintegration
89.07
Mean energy (keV)
140.5
Dosimetry - Tc-99m-Sulfur Colloid (15)
Organ
Liver
Spleen
Bone marrow
Total body
Ovaries
Testes
rads/15 mCi
5.08
3.20
0.43
0.28
0.08
0.003
mGy/555 MBq
50.8
32.0
4.3
2.8
0.8
0.03
References
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Datz FL, Taylor A: The clinical use of radionuclide bone marrow imaging. Sem Nucl
Med 15:239-259, 1985.
Fordham EW, Ali A: Radionuclide imaging of bone marrow. Sem Nucl Med
18:222-239, 1981.
Reske SN: Recent advances in bone marrow scanning. Eur J Nucl Med
18:203-221, 1991.
Linden A, Zankovich R, Theissen P, et al: Malignant lymphoma: Bone marrow
imaging versus biopsy. Radiology 173:335-339, 1989.
Palestro CJ, Sawyer AJ, Kim CK, et al: Infected knee prosthesis: Diagnosis with
In-111 leukocyte, Tc-99m sulfur colloid, and Tc-99m MDP imaging. Radiology
179:645-648, 1991.
Seabold JE, Nepola JV, Marsh JL, et al: Postoperative bone marrow alterations:
Potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte
scintigraphy. Radiology 180:741-747, 1991.
Palestro CJ, Kim CK, Sawyer AJ, et al: Total-hip arthroplasty: Periprosthetic
indium-111-labeled leukocyte activity and complementary technetium-99m-sulfur
colloid imaging in suspected infection. J Nucl Med 31:1950-1955, 1990.
Klingensmith WC, Spitzer VM, Fritzberg AR, et al: Normal appearance and
reproducibility of liver-spleen studies with Tc-99m-sulfur colloid and
Tc-99m-microalbumin colloid. J Nucl Med 24:8-13, 1983.
McAfee JG, Subramanian G, Aburano T, et al: A new formulation of Tc-99m
minimicroaggregated albumin for marrow imaging: Comparison with other colloids,
In-111 and Fe-59. J Nucl Med 23:21-28, 1982.
Axelsson KB, Jacobson H: Quantitative evaluation of four Tc-99m colloids for bone
marrow scintigraphy using single photon emission computed tomography. Nucl
Med Commun 12:135-145, 1991.
Lilien DL, Berger HG, Anderson DP, et al: In-111-chloride: A new agent for bone
marrow imaging. J Nucl Med 14:184-186, 1972.
McNeil BJ, Holman BL, Button LN, et al: Use of indium chloride scintigraphy in
patients with myelofibrosis. J Nucl Med 15:647-651, 1974.
Horn ML, Bennett LR, Marciano D: Evaluation of aplastic anemia with indium
chloride In 111 scanning. Ann Intern Med 140:299-303, 1980.
14.
15.
43-Tc-99m: In MIRD: Radionuclide Data and Decay Schemes, DA Weber, KF
Eckerman, AT Dillman, JC Ryman, eds, Society of Nuclear Medicine, New York,
1989, pp 178-179.
MIRD Dose Estimates Report No. 3: Summary of current radiation dose estimates
to humans with various liver conditions from Tc-99m-sulfur colloid. J Nucl Med
16:108A, 1975
Normal Findings
Fordham EW, Ali A: Radionuclide imaging of bone marrow. Sem Nucl Med
18:222-239, 1981.
Last edited 2/11/2014
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