Open AccessAssessment of sites of marrow and extramedullary hematopoiesis by hybrid imaging in primary myelofibrosis patients
Author(s) -
OjedaUribe Mario,
Morel Olivier,
Ungureanu Constantin,
Desterke Christophe,
Le BousseKerdilès MarieCaroline,
Boulahdour Hatem
Publication year - 2016
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.835
Subject(s) - myelofibrosis , extramedullary hematopoiesis , bone marrow , haematopoiesis , nuclear medicine , medicine , polycythemia vera , single photon emission computed tomography , spleen , emission computed tomography , radiology , pathology , positron emission tomography , biology , stem cell , genetics
We investigated noninvasive procedures by hybrid imaging to assess the sites of active or inactive hematopoiesis in patients with primary myelofibrosis ( PMF ). To this end, we used two radionuclides, technetium 99m ( 99m Tc) and indium 111‐chloride ( 111 In‐Cl 3 ), coupled with single‐photon emission tomography/computed tomography ( SPECT / CT ). We studied five patients with PMF and one with secondary myelofibrosis ( MF ). The classical pattern of lower fixation of both tracers at the axial skeleton where the myelofibrotic process occurs and the reactivation of sites of active hematopoiesis at the distal skeleton were confirmed. Coupling both radionuclides to SPECT / CT imaging allowed for more precise visualization of the sites of extramedullary hematopoiesis as those observed in the spleen and liver. Splenic high uptake of 111 In‐Cl 3 coupled with SPECT / CT represents a pathognomonic feature of PMF . We conclude that, the hybrid imaging procedures that we studied might constitute an alternative noninvasive method for the screening of the whole‐body marrow and, by this way, to assess the impact of targeted therapies in PMF patients in whom it is well known that the distribution of the hematopoietic active areas is disturbed. Hybrid imaging could also be useful for diagnostic purposes in cases of early PMF or in suspected cases of myelofibrosis secondary to polycythemia vera or essential thrombocythemia.