Scintigraphic Evaluation of Hematologic Diseases with Tc-99m Labeled Antigranulocyte Antibody / 대한혈액학회지

BACKGROUND: Bone marrow scintigraphy using Tc-99m labeled antigranulocyte antibody has been reported to be able to evaluate bone marrow status. We have performed antigranulocyte antibody scan and hematopoietic activity in order to identify bone marrow status in patients with hematologic diseases. METHODS: Sixty-nine patients were enrolled in this study from October 1995 to May 1997. Images were acquired at four and twenty-four hour after injecion of 20mCi 99mTc labeled antigranulocyte antibody (BW 250/183). Patients were divided into four groups according to scintigraphic findings, those with increased marrow uptake (marrow expansion), decreased uptake, focal defect and normal findings. RESULTS: Leukemias and myelodysplastic syndromes frequently showed bone marrow expansion. Seventeen of 21 patients (81%) with AML, and all of ALL and biphenotypic leukemias showed bone marrow expansion. Five of 6 with CML, all Hodgkin's diseases and 3 of 4 MDS also showed marrow expansion. In contrast, all aplastic anemia patients showed decreased marrow uptake, and extra-axial noted in 2 patients with aplastic anemia. All of ten patients with multiple myeloma and 2 of 4 (50%) with Hodgkin disease showed focal marrow defects. Three of 11 with non-Hodgkin lymphoma and 4 of 21 with AML also showed focal marrow defects. CONCLUSION: Bone marrow scintigraphy using antigranulocyte antibody has clearly demonstrated the distribution of bone marrow in various hematologic diseases. Thus, it seems to be a useful method in the assessment of bone marrow status in patients with hematologic disease.

Detection of Osteomylitis Using a Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy / 대한핵의학회잡지

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. MATERIALS AND METHODS: The study population was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 p;tients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. RESULTS: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. CONCLUSION: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis.

Bone Marrow Scintigraphy with Antigranulocyte Antibody in Multiple Myeloma: Comparison with Simple Radiography and Bone Scintigraphy / 대한핵의학회잡지

PURPOSE: Simple X-ray study and bone scan have limiitations for early diagnosis of bone or bone marrow lesions in multiple myeloma. The purpose of this study was to evaluate the diagnostic usefulness of bone marrow imrnunoscintigraphy using anti-granulocyte monoclonal antibody for the evaluation of bone involvement I:n multiple myeloma. MATERIALS AND METHODS: In 22 patients (Male: 15, Female: 7) with multiple myeloma, we perforrned whole-body immunoscintigraphy using ' Tc-labelled antigranulocyte antibody (BW 250/183, Scintimum Granulozyt CIS, France) and compared the findings with those of simple bone radiography and "" Tc-MDP bone scan. Abnonnal findings in bone marrow scintigraphy were, considered to be present in case of expansion of peripheral bone marrow or focal photan defect in axial bones. RESULTS: Marrow expansion was noted in 15 of 22 patients (68%). Focal photon defects were found in 18 patients (82%). While one (33%) of 3 patients with Stage II disease showed focal defects in bone marrow scan, abnormal focal defects were observed in 17 of 19 (90%) patients with Stage III. Among 124 focal abnormal sites which were observed in bone marrow scan, bone scan or simple bone radiography, bone rnarrow scan detected 92 sites (74%), whereas 82 sites (66%) were observed in simple bone radiography(58 sites, 47%) or bone scan(40 sites, 32%). Fifty-one (41%) out of 124 bone lesions were detected by bone marrow scan only, and located mostly in thoracolumbar spine. CONCLUSION: Bone marrow scan using "" Tc-labelled antigranulocyte antibody seems to be a more sensitive procedure for the detection of pathologic bone lesions than simple bone X-ray ar bone sean in patients with multiple myeloma.

Vertebral compression fractures: distinction between benign and malignant causes with Tc-99m labeled antigranulocyte antibody immunoscintigraphy / 영남의대학술지

We evaluated the effectiveness of Tc-99m labeled antigranulocyte antibody immunoscintigraphy in differentiating the causes of vertebral compression fracture. This study involved 16 patients with vertebral compression fracture; 8 were due to trauma or osteoporosis, 3 were due to metastasis and 5 were due to tuberculous spondylitis. We retrospectively analyzed the location and the extent of decreased tracer uptake in tomographic images of Tc-99m labeled antigranulocyte antibody immunoscintigraphy. Eight patients had a 16 vertebral compression fractures due to trauma or osteoporosis , three patients had a 3 vertebral compression fractures due to metastasis and 5 patients had a 6 vertebral compression fractures due to tuberculous spondylitis. Sixteen vertebral compression fractures by trauma or osteoporosis showed a normal tracer uptake in pedicle, laminar and spinous process, but there was noted with 6 decreased uptake, 8 absence of tracer uptake and 2 normal tracer uptake in the vertebral body. Two vertebral compression fractures by metastasis showed the absence of uptake in vertebral body, pedicle, laminar and spinous process, and one showed an absence of vertebral body and spinous process. Six vertebral compression fractures by tuberculous spondylitis showed the absence of uptake in six compression fractures, the absence of pedicle in five compression fractures. We concluded Tc-99m labeled antigranulocyte antibody immunoscintigraphy may be helpful to differentiate the causes of vertebral compression fractures.