• Title/Summary/Keyword: Bone marrow immunoscintigraphy

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Bone Marrow Immunoscintigraphy for the Detection of Skeletal Metastasis in Malignant Tumors: A Comparison with $^{99m}Tc$-MDP Bone Scan (악성종양에서 골수면역신티그라피를 이용한 골수전이의 평가 : $^{99m}Tc$-MDP 뼈스캔과의 비교)

  • Lee, Kyung-Han;Choi, Chang-Woon;Bang, Yung-Jue;Chung, Jun-Key;Chung, Hong-Keun;Lee, Myoung-Chul;Kim, Byoung-Kook;Kim, Noe-Kyeong;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.89-97
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    • 1994
  • Although bone scan is a highly sensitive test for detecting bone metastasis, its findings are often limited in specificity and cannot be used for assessing the bone marrow. Bone marrow scintigraphy may provide useful information but previous experience with radiolabelled colloid has been disappointing. Recently, $^{99m}Tc$ labeled anti-granulocyte monoclonal antibody (anti-NCA-95 MAb) has been introduced as a new bone marrow imaging agent. To evaluate the usefulness of $^{99m}Tc$ anti-NCA MAb bone marrow scans for detecting skeletal metastasis, bone marrow scans of 44 malignant tumor patients were evaluated and compared with bone scan findings. Bone scan showed abnormal lesions in 26(59%) cases, and 18 of these patients also had an abnormal bone marrow scan. Seven of the 8 patients who had normal bone marrow scan despite bone scan lesions were confirmed to be free from metastasis. There was one case with a marrow defect despite normal bone scan but the presence of metastasis was not determined due to loss of follow up. Bone scan demonstrated a total of 64 lesions while bone marrow scan showed 38 lesions. Fifty percent (32/64) of the bone scan lesions had matching marrow defects while the remaining 50% did not. Most of these non matched lesions were suggested to be nonspecific lesions such as rib fractures or degenerative change. Meanwhile bone marrow scan was able to detect 6 new lesions not detected by bone scan, bit metastasis in each lesion was not confirmed. Bone marrow scan was also helpful in assessing equivocal bone scan lesions to be of metastatic nature in 10 patients by demonstrating a matched marrow defect. Thus $^{99m}Tc$ anti-NCA MAb bone marrow scan can help exclude metastasis in patients with nonspecific bone scan lesions and may be able to detect metastatic lesions not seen with bone scan. It appears useful as a complementary study to bone scan in evaluating malignant tumor patients.

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Bone Marrow Scintigraphy with Antigranulocyte Antibody in Multiple Myeloma: Comparison with Simple Radiography and Bone Scintigraphy (항과립구 항체 골수스캔을 이용한 다발성 골수종 병변의 평가: 단순골X-선점사 및 골스캔과의 비교)

  • Kim, Dong-Hwan;Lee, Jae-Tae;Baek, Jin-Ho;Jung, Jin-Tae;Hyun, Dong-Woo;Chun, Kyung-Ah;Lee, Young-Hak;Sohn, Sang-Kyun;Song, Hong-Seok;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.354-364
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    • 1998
  • Purpose: Simple X-ray study and bone scan have limitations 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 immunoscintigraphy using anti-granulocyte monoclonal antibody for the evaluation of bone involvement in multiple myeloma. Materials and Methods: In 22 patients (Male: 15, Female: 7) with multiple myeloma, we performed whole-body immunoscintigraphy using $^{99m}Tc$-labelled antigranulocyte antibody (BW 250/183, Scintimum $Granulozyt^{(R)}$ CIS, France) and compared the findings with those of simple bone radiography and $^{99m}Tc$-MDP bone scan. Abnormal findings in bone marrow scintigraphy were, considered to be present in case of expansion of peripheral bone marrow or focal photon 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 marrow 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 $^{99m}Tc$-labelled antigranulocyte antibody seems to be a more sensitive procedure for the detection of pathologic bone lesions than simple bone X-ray or bone scan in patients with multiple myeloma.

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Central and Peripheral Distribution of Bone Marrow on Bone Marrow Scintigraphy with Antigranulocytic Antibody in Hematologic Malignancy (혈액 종양 질환에서 항과립구항체 골수 스캔을 이용한 중심 골수와 말초 골수 분포의 분석)

  • Kang, Do-Young;Lee, Jae-Tae;Sohn, Sang-Kyun;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.5
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    • pp.298-305
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    • 2002
  • Purpose: Bone marrow scintigraphy has been used to evaluate the status of bone marrow in various hematologic disorders. We have analyzed the peripheral distribution pattern and central uptake ratio of bone marrow using anti-NCA-95 monoclonal antibody and the their correlation in patients with various hematologic malignancy. Materials and Methods: Bone marrow immunoscintigraphy was performed using Tc-99m anti-granulocyte monoclonal mouse antibody BW 250/183. Fifty patients were classified into four groups; 11 with acute myelogenous leukemia, 12 with acute lymphocytic leukemia, 15 with lymphoma and 12 with myelodysplastic syndrome. The extension of peripheral bone marrow was categorized into four grades: I, II, III and IV. The activity of central bene marrow was expressed as sacroiliac uptake ratio. Results: The patient's number was 4 in grade I, 27 in grade II, 15 in grade III and 4 in grade IV according to extension of peripheral bone marrow. The extension of peripheral bone marrow was marked (58% in grade III and IV) in myelodysplastic syndrome and acute lymphocytic leukemia and mild (93% in grade I and II) in lymphoma. Sacroiliac uptake ratio was highest ($8.5{\pm}4.0$) in myelodysplastic syndrome and lowest ($5.9{\pm}3.6$) in acute myelogenous leukemia, but not significantly different among four patient groups (p>0.05). Sacroiliac uptake ratio of whole patients was significantly different among four grades (p=0.003), but there was not correlated between grade of peripheral bone marrow and sacroiliac uptake ratio (r=0.05). Conclusion: The pattern of peripheral bone marrow extension and activity of central hemopoietic marrow were not specific to the disease entities. Response of hemopoietic bone marrow may be evaluated on both peripheral and central bone marrow in patients with hematologic malignancy.

$^{99m}Tc$ Labeling Kit Preparation and Characteristics of Anti-NCA-95 Monoclonal Antibody (항 NCA-95 단일클론항체의 $^{99m}Tc$표지 키트 제조 및 특성 연구)

  • Hong, Mee-Kyoung;Jeong, Jae-Min;Chung, June-Key;Choi, Seok-Rye;Kim, Chae-Kyun;Lee, Yong-Jin;Lee, Dong-Soo;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.541-547
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    • 1996
  • The previous monoclonal antibody labeling method for bone marrow immunoscintigrapy was complicated and laborious for clinical application. Also it showed a relatively low labeling efficiency. To improve this procedure, we compared several direct labeling methods of $^{99m}Tc$. 1) The labeling efficiency in the method using gluconate as a transchelator was low (40-70%), but immunoscintigraphy using this radiotracer produced a clear image. 2) To improve labeling efficiency, ${\beta}$-mercaptoethanol was removed after reduction. The labeling efficiency was improved up to 70-80%, but the radioactivity of the blood pool was high. 3) The higest labeling efficiency (>90%) and best quality images could be obtained by using MDP as a transchelating agent. It did not require additional procedures for separation of labeled antibodies. The immunoreactivity of this antibody was 60%. Residual MDP which can be taken up by the bone could be removed by PD-10 column. The reduced antibodies were stable with a high labeling efficiency (>90%) for up to 47 days by deep freezing. We concluded that the improved procedure for $^{99m}Tc$ labeling of anti-NCA-95 monoclonal antibody using MDP as a transchelating agent will be a simple and useful method for clinical application.

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