Bone marrow scintigraphy with 99m Tc labelled monoclonal anti-NCA 90 Fab' fragment: a feasibility study and comparison of bone marrow uptake with 99m Tc labelled monoclonal anti-NCA 95 antigranulocyte antibody.
The aim of this retrospective study was to evaluate the usefulness of 99mTc labelled monoclonal anti-NCA 90 antigranulocyte antibody Fab' fragment (MN3 Fab') as a bone marrow imaging agent. One hundred and ten planar scans (88 patients) of the lumbar and sacroiliac regions as well as whole-body scans were performed after 1, 5 and 24 h. All the scans were evaluated visually and bone marrow uptake was determined semiquantitatively as count density ratio from sacroiliac-minus-background to background area. Results were compared to 50 age-matched patients with normal bone marrow scans obtained with the intact 99mTc labelled monoclonal anti-NCA 95 antigranulocyte antibody (BW 250/183) in a previous study. Seventy-three patients showed a physiological activity distribution in the central bone marrow. Ten patients showed a bone marrow extension, while in two patients central bone marrow depression was observed. Evaluation of the ribs, lower thoracic and upper lumbar spine was hampered by soft-tissue activity. Bone marrow uptake was 1.36+/-0.56 after 1 h, decreased thereafter and was significantly lower than that of BW 250/183 (P < 0.001). In conclusion, MN3 Fab' cannot be recommended for bone marrow scintigraphy, because relevant parts of the haemopoietically active bone marrow are not accessible to visual evaluation. A significant role of the semiquantitative evaluation of MN3 Fab' bone marrow uptake in patients with potential marrow depression seems unlikely.
Ivancevic
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Department of Nuclear Medicine, University Hospital Charité, Humboldt University, Berlin, Germany. ivancevic@charite.de
Huic
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D
Wolter
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Munz
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DL
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000493:pharmacokinetics; D000951:Antigens, Neoplasm; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000378:metabolism*; D015815:Cell Adhesion Molecules; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006098:Granulocytes / Q000000981:diagnostic imaging / Q000276:immunology; D006410:Hematopoiesis; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000493:pharmacokinetics; D008875:Middle Aged; D016719:Radioimmunodetection / Q000379:methods* / Q000706:statistics & numerical data; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013667:Technetium / Q000493:pharmacokinetics*
D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm; D015815:Cell Adhesion Molecules; D008562:Membrane Glycoproteins; D013667:Technetium