Studies of bone marrow scintigrams with sup(99m)technetium sulfur colloid on various hematological disorders

One hundred and eighty-five bone marrow scintigraphy on the whole body was performed on eight healthy adults and 151 patients with various hematologic diseases including 64 leukemia, 41 anemia, 23 other malignancy, etc. The positions of the investigated bone marrow were divided into the central marrow (five positions on the trunk bones) and the peripheral marrow (11 positions on the upper and 11 positions on the lower extremities) on the scintigram. The bone marrow scintigram was estimated by following three criteria. The first, ''Yuu-ryoiki'' (positive area), was the existence of sup(99m)Tc sulfur colloid accumulation on bone marrow (two grades; presence or absence). The second, ''Bunpu-kei'' (distribution form), was the extent of the sup(99m)Tc accumulation area of the investigated bone marrow and was divided into five grades. The last, ''Kido'' (intensity of radioactivity), was the density of the sup(99m)Tc accumulation on the area and was divided into five grades. Using this estimation, in the diseases with bone marrow hyperplasia such as Primary Thrombocythemia and Hemolytic Anemia, ''Yuu-ryoiki'' was enlarged, ''Bunpu-kei'' was extended, and ''Kido'' was increased comparing with those in healty adult. In contrast, in the diseases with bone marrow hypoplasia such as Myelofibrosis and Aplastic Anemia, ''Yuu-ryoiki'' was reduced, ''Bunpu-kei'' was contracted, and ''Kido'' was decreased. However, the enlargement of ''Yuu-ryoiki'' did not always mean bone marrow hyperplasia. The author could evaluate not only the range and distribution of hemopoiesis as a whole in malignant or benign diseases but also the residual effective hemopoiesis to know the suitable time of the initiation of the therapy or to predict the prognosis of these cases. In this study it was shown that the bone marrow scintigraphy with sup(99m)Tc sulfur colloid was an useful method to estimate the hemopoietic activity of the bone marrow. (J.P.N.)