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Review
. 2011 Jan;38(1):166-78.
doi: 10.1007/s00259-010-1531-0. Epub 2010 Jul 13.

Radionuclide imaging of bone marrow disorders

Ali Agool  1 , Andor W J M Glaudemans, Hendrikus H Boersma, Rudi A J O Dierckx, Edo Vellenga, Riemer H J A Slart
Affiliations
Review

Radionuclide imaging of bone marrow disorders

Ali Agool et al. Eur J Nucl Med Mol Imaging. 2011 Jan.

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 (99m)Tc-nanocolloid, (99m)Tc-sulphur colloid, (111)In-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 (18)F-FDG and (18)F-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.

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Figures

Fig. 1
Fig. 1
Different patterns of haematopoietic bone marrow imaging. a Normal pattern of haematopoietic bone marrow activity in the central skeleton and skull. b Expansion of haematopoietic bone marrow activity more distally in the extremities. c Reduced haematopoietic bone marrow activity in the central compartment of the skeleton and skull, as seen in AA. d MF with extramedullary erythropoiesis in the spleen and liver and reduced haematopoietic bone marrow activity in the central compartment of the skeleton and skull
Fig. 2
Fig. 2
FDG PET image in a patient with multiple myeloma. Lesions are visible in the ribs, right scapula and sternum
Fig. 3
Fig. 3
a Normal distribution of 18F-FLT PET. b The effect of radiotherapy on bone marrow activity in (a) the fourth lumbar vertebra and (b) the midthoracic vertebrae
Fig. 4
Fig. 4
Different bone marrow patterns in 18F-FLT PET. a A patient with AA. Several patchy hot lesions with increased proliferative activity are visible in the spine and femora, and mainly higher liver uptake compared to controls. b A patient with MDS shows a relatively homogeneous 18F-FLT PET pattern in the bone marrow of the spine and relative heterogeneous expansion in the extremities, but the extremities can also be homogeneous. There is normal uptake in the liver and spleen. c A patient with MPD shows homogeneously increased uptake and extensive peripheral bone marrow expansion into extremity bones and no elevated uptake in the liver or (enlarged) spleen. d A patient with MF shows low uptake in the bone marrow compartment. Elevated uptake in the enlarged spleen and moderate elevated uptake in the liver as a result of extramedullary haematopoiesis. e A patient with thoracic paravertebral EMH with β-thalassaemia
See this image and copyright information in PMC

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