title: Assessment of sites of marrow and extramedullary hematopoiesis by hybrid imaging in primary myelofibrosis patients.
abstract: 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-Cl3 ), 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-Cl3 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.
authors: Service d'Hématologie Clinique et Unité de Thérapie Cellulaire, Hôpital E Muller, GHR Mulhouse Sud-Alsace, Mulhouse, France. ojeda-uribem@ghrmsa.fr.
authors: Mario
authors: M
authors: Ojeda-Uribe
authors: Pôle d'Imagerie, CHU Besançon, France.
authors: Olivier
authors: O
authors: Morel
authors: Pôle d'Imagerie, CHU Besançon, France.
authors: Constantin
authors: C
authors: Ungureanu
authors: INSERM UMS33, Hôpital Paul-Brousse, Villejuif, France.|Université Paris Sud 11, Villejuif, France.
authors: Christophe
authors: C
authors: Desterke
authors: Université Paris Sud 11, Villejuif, France.|INSERM U1197, Hôpital Paul-Brousse, Villejuif, France.
authors: Marie-Caroline
authors: MC
authors: Le Bousse-Kerdilès
authors: Pôle d'Imagerie, CHU Besançon, France.|EA 4662-Nanomedicine Lab, Imagery and Therapeutics, Hôpital J Minjoz, CHU Besançon, France.
authors: Hatem
authors: H
authors: Boulahdour
mesh_terms: D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D007249:Inflammation; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D064847:Multimodal Imaging / Q000379:methods; D055728:Primary Myelofibrosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D011868:Radioisotopes; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012863:Skeleton / Q000000981:diagnostic imaging; D013154:Spleen / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D011868:Radioisotopes; D019275:Radiopharmaceuticals
keywords: Extramedullary hematopoiesis; SPECT; hybrid imaging; primary myelofibrosis; radionuclides; spleen