• The Korean Journal of Nuclear Medicine
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• v.37 no.3
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• pp.171-177
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• 2003

PURPOSE: To asess the ability of FDG PET for the detection of bone marrow infiltration compared to iliac crest biopsy in patients with lymphoma. MATERIALS AND METHODS: Seventy-three patients (30 females and 43 males, mean age of 47 years old) with malignant lymphoma (4 Hodgkin's disease, HD and 69 Non-Hodgkin's lymphoma, NHL) were included. FDG PET was performed for staging in 53 patients and to assess treatment response after the completion of chemotherapy in 20 patients. Final conclusions were based on biopsy, other imaging studies, or clinical follow-up. RESULTS: There were 54 (74%) of the 73 patients in whom FDG PET and iliac crest biopsy were concordant. Forty-seven of the 54 patients showed concordant negative results while the remaining 7 patients had concordant positive results. Of 19 patients with discordant results, FDG PET accurately detected bone marrow infiltration in 6 patients with negative iliac crest biopsy. On the contrary, iliac crest biopsy identified bone marrow infiltration in 12 or the 19 patients. In remaining one of the 19 patients with discordant results, iliac crest biopsy was true negative but FDG PET was falsely positive. CONCLUSION: FDG PET seems to be an adjunct in detecting marrow infiltration that may not be revealed by iliac crest biopsy at staging. For the assessment of treatment roponse, it may be less helpful than biopsy in detecting microscopic residual disease in the bone marrow.

• The Journal of the Korean dental association
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• v.25 no.6 s.217
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• pp.541-548
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• 1987

골수염은 조기에 적절한 치료를 하지않으면 중대한 후유증이 초래되므로 신속한 진단과 치료가 요구된다. 골수염을 진단하기 위해서는 구강검진, 방사선검사, 병리조직학적 검사, 혈액 및 세균배양검사와 골스캔등이 필요하다. 골수염의 감염과정은 골에 파괴적 및 재생적 변화의 양자를 모두 일으키지만 X선사진소견에서는 임상증상이 발현된 후 약 10내지 14일이 경과되어야만 골변화를 관찰할 수 있으며 그 이전에는 대체로 비특이적 연조직의 종창만을 보인단. 반면에 골스캔을 이용하면 급성염증기의 골질환을 감견하기가 용이하다. 골스캔제의 국소골섭취의 증가는 골의 어떤 부위에서 대사능이나 혈류가 증가된 경우에 일어나기 때문에, 실제로 임상증상이 발현된 후 24시간정도의 조기에 골스캔상은 양성반응을 보인다. 즉 골의 국소적 병변은 어느정도 신생골 형성과 골파괴가 같이 수반되어있고 이러한 신생골은 골스캔제와 친화력이 강하므로 골형성반응을 야기하는 어떠한 병변이라도 골스캔에 의하여 발견될 수 있다. 임상적으로 골수염에 대하여 골스캔을 시행하는 경우는 골수염의 조기진단, 골수염과 봉와직염과의 감별진단, 만성 공수염의 악화여부 및 치료에 대한 반응을 monitoring하기 위해서 시행된다.

• Investigative Magnetic Resonance Imaging
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• v.3 no.2
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• pp.113-124
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• 1999

종래의 영상진단 방법은 골수의 이상을 검사하는데 상당한 제한점이 있는 상황에서 MR 영상은 골수를 칩습한 병변을 직접 묘출할 있는 우선적인 영상진단법으로 그 이용이 점차 증대되고 이다. 비록 골수 천자나 생검에 비해 조직학적 진단의 특이성은 떨어지나 환자의 임상증세와 혈액상을 연관지어 MR 영상 소견을 판독하면 골수의 병변을 진단하고 그 치료에 관한 반응을 해석하는데 유용한 정보를 줄 수 있으리라 기대된다.

• 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.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.35-39
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• 2009

Purpose: Increased FDG uptake in the bone marrow has been reported in patients taking erythropoietin or granulocyte-colony stimulating factor (G-CSF). The aim of this study is to investigate the correlation between F-18 FDG uptake in the bone marrow and bone marrow finding, hematological parameters. Materials and Methods: Twenty patients who had diffuse FOG uptake at the bone marrow and received hematological examinations, bone marrow biopsy within 10 days before or after PET/CT were enrolled in this study. Among them, 11 patients were excluded; 4 patients received G-CSF or erythropoietin before PET/CT. Seven patients showed definite pathology in a bone marrow biopsy. The parameters included the measurement of WBC, hemoglobin, platelet and cellularity of the bone marrow. Results: Bone marrow FDG uptake was correlated with a low hemoglobin but not WBC, platelet. Histopathologic findings in marrow biopsies were various: normal finding (n=3), hyperplasia of granulocytic cells (n=2), eosinophilic hyperplasia (n=1), reactive lymphoid nodules (n=1), hypercelluar marrow (n=1), hypocelluar marrow (n=1). All patients except two, showed normal marrow celluarity. Conclusion: FOG uptake by bone marrow correlated with anemia but not WBC, platelet, bone marrow cellularity.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.505-519
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• 2024

MRI plays a crucial role in bone marrow (BM) assessment, and has very high sensitivity in diagnosing marrow disorders. However, for radiologists who may not frequently encounter pediatric imaging, distinguishing pathologic BM lesion from normal BM can be challenging. Conditions involving the BM in pediatric patients, such as leukemia and metastatic neuroblastoma, often manifest with diverse musculoskeletal symptoms and may be diagnosed using musculoskeletal MRI examinations. Accurate interpretation of pediatric MRI requires not only an understanding of the normal composition of BM but also an awareness of age-related developmental changes in the marrow and familiarity with conditions that commonly involve pediatric BM. We aim to describe the composition of normal BM and outline the normal and abnormal MRI findings in pediatric BM. Additionally, we aim to present clinical cases of malignant BM disorders including leukemia, neuroblastoma metastasis, and other malignant BM disorders.

• Journal of Yeungnam Medical Science
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• v.18 no.2
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• pp.239-245
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• 2001

Background: Acute idiopathic thrombocytopenic purpura(ITF) is one of the common hematologic disorders in children. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. This study was performed to examine the proper indication of BMA in acute childhood ITF. Materials and Methods: The medical records and BMA reports of children with the provisional diagnosis of acute ITP were reviewed from January 1984 to December 2000. Patients were divided into two groups, one with typical and another with atypical clinical and hematological features of acute ITP. Typical acute ITP group was characterized by the history of previous viral infection, well being appearance, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WEC, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of $50{\times}l0^9/L$ or lower was the cutoff level. Results: Total 120 children with the provisional diagnosis of acute ITP were included. One hundred eighteen of them were confirmed to have acute ITP by BMAs. Of these, 66 had typical and 54 had atypical features. All of typical features and 52 of 54 with atypical features of acute ITP were confirmed to have acute ITP by BMAs. Two patients with atypical features of acute ITP were diagnosed as aplastic anemia and myelodyspalstic syndrome, respectively, by BMAs. Conclusion: This study concludes that BMA is not needed for the children with typical features of acute ITP but it is needed for the children with atypical features of acute ITP to rule out other hematologic disorders.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.198-206
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• 2000

Background : Pulmonary complications following bonemarrow transplantation (BMT) are common and associated with a high mortality rate. We investigated the yield, safety, and impact of fiberoptic bronchoscopy (FOB) for diagnosis of postBMT pneumoniae. Methods : From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with respiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL (bronchoalveolar lavage), TBLB (transbronchial lung biopsy), PSB (protected specimen brush). Results : The characteristics of the subjects were as follows : 37 males, 15 females, mean age of 31.3 years(l7-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following : 12 cytomegalovirus (CMV) (21.4 %), 7 pneumocystis carinii (PC) (12.5 %), 11 CMV with PC (19.6 %), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases (23.2%), 13 died of CMV pneumoniae (n=2), PCP (n=2),mixed infection with CMV and PC (n=3), underlying GVHD (n=1), underlying leukemia progression (n=1), or respiratory failure of unknown origin (n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleeding and 1 episode temporary hypoxemia. Conclusion : Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.149-156
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• 2005

Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.4
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• pp.292-297
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• 2015

Research of thyroid cancer, liver cancer, and lung cancer has been reported in Korea. However microRNA research of multiple myeloma has never been reported. Hence we intended to confirm whether microRNA can be utilized as a diagnostic marker to patients of multiple myeloma. We also intended to evaluate whether microRNA can be detected in paraffin-embedded tissue (FFPE). This research was conducted targeting 8 samples from patients of multiple myeloma who do not have any other diseases, and 2 control samples. From January 2010 to July 2012, we selected miR-15a, miR-16, miR-21, miR-181a and miR-221 as microRNA target genes. It was decided that for a sample to be significant, the results should show values more than 1.5 or less than -1.5. Our findings of fold change were highly significant in miR-15a with a value of 37.5% (3/8). From these studies, we learned that miR-15a is useful with westerners. miR-221, on the other hand, shows conflicts with westerners, so more research will be needed in this area. In addition, it was confirmed that microRNA can be detected in paraffin embedded tissue (FFPE).