• 대한핵의학회지
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• 제28권1호
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• pp.89-97
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• 1994

Although bone scan is a highly sensitive test for detecting bone metastasis, its findings are often limited in specificity and cannot be used for assessing the bone marrow. Bone marrow scintigraphy may provide useful information but previous experience with radiolabelled colloid has been disappointing. Recently, $^{99m}Tc$ labeled anti-granulocyte monoclonal antibody (anti-NCA-95 MAb) has been introduced as a new bone marrow imaging agent. To evaluate the usefulness of $^{99m}Tc$ anti-NCA MAb bone marrow scans for detecting skeletal metastasis, bone marrow scans of 44 malignant tumor patients were evaluated and compared with bone scan findings. Bone scan showed abnormal lesions in 26(59%) cases, and 18 of these patients also had an abnormal bone marrow scan. Seven of the 8 patients who had normal bone marrow scan despite bone scan lesions were confirmed to be free from metastasis. There was one case with a marrow defect despite normal bone scan but the presence of metastasis was not determined due to loss of follow up. Bone scan demonstrated a total of 64 lesions while bone marrow scan showed 38 lesions. Fifty percent (32/64) of the bone scan lesions had matching marrow defects while the remaining 50% did not. Most of these non matched lesions were suggested to be nonspecific lesions such as rib fractures or degenerative change. Meanwhile bone marrow scan was able to detect 6 new lesions not detected by bone scan, bit metastasis in each lesion was not confirmed. Bone marrow scan was also helpful in assessing equivocal bone scan lesions to be of metastatic nature in 10 patients by demonstrating a matched marrow defect. Thus $^{99m}Tc$ anti-NCA MAb bone marrow scan can help exclude metastasis in patients with nonspecific bone scan lesions and may be able to detect metastatic lesions not seen with bone scan. It appears useful as a complementary study to bone scan in evaluating malignant tumor patients.

• 응용통계연구
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• 제1권2호
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• pp.45-60
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• 1987

癌 환자에서 癌의 骨髓轉移 여부를 판정하는 것은 임상적으로 매우 중요하다. 癌의 骨髓轉移에 대한 說明變數 을 찾기 위하여 癌의 骨髓轉移가 있는 ？ 60 例와 公水轉移가 없는 환자 41 例를 대상으로 로지스틱 回歸分析을 시도하였다. 上記 資料는 1977년 1월부터 1985년 12월까지 연세대학교 의과대학 부속 세브란스 병원의 기록을 後向的으로(retrospectively) 조사하여 수집되었다. 가장 적합도가 높은 로지스틱 回歸分析의 說明變數를 기초로 하여 임상적으로 적용이 편리한 癌의 骨髓轉移에 대한 判定基準을 構成하였고, 이러한 判定基準의 銳敏度(sensitivity)와 特異度(specificity)도 계산되었다.

• 대한핵의학회지
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• 제37권6호
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• pp.428-436
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• 2003

목적: 암환자의 추적 골스캔에서 관절주위 섭취증가를 보이는 경우 관절염 이외의 원인으로 말초골수 확장에 의한 이차적 골섭취 증가를 생각할 수 있다. 이 때 막초골수 확장의 원인으로. 즉 중심골수 침범에 의한 이차적 말초골수 확장과 만성빈혈에의한 이차적 골수확장의 감별에 골스캔상 전신골섭 취계수 증가 소견이 도움을 주는지 알아보기 위해 본 연구에서는 암환자의 골스캔상 관절주위 섭취증가 소견을 보인 12명의 환자에서 골스캔과 골수스캔 소견을 비교 분석하였다. 대상 및 방법: 추적 골스캔에서 관절주위 섭취증가를 보인 12명의 암환자에서 1 주일 이내에 Tc-99m colloid 골수스캔을 시행하였다. 골스캔상 전신골섭취계수 증가 여부를 알아보고 골수스캔에서는 중심골 섭취감소 여부와 말초골수 확장여부를 각각 알아 보았다. 임상적으로 관절염, 관절통 여부와 빈혈이 동반되는지 알아 보았다. 결과: 원발암의 진단명은 혈액암 5례, 위암 3례, 유방암 2례, 전립선암 1례, 폐암 1례였다. 남녀비는 7:5 이고 평균연령은 47.5 14.3세였다. 골스캔에서 전신골섭취계수 증가는 3례에서 관찰되었으며 모두 골수스캔상 중심골수 섭취감소 소견과 말초골수 확장 소견을 보여 전신 골수전이로 진단되었다. 골스캔상 전신골섭취계수 증가를 보이지 않았던 9례 중 1례는 중심골수 섭취가 감소되고 말초골수가 확장되었으며 만성골수성백혈병의 급성기로 진단되었다. 7례는 중심골수 섭취는 정상이었고 말초골수 확장이 관찰되었으며 빈혈이 동반되어 있어 악성질환의 만성빈혈로 추정되었다. 결론: 암환자의 추적 골스캔에서 관절주위 섭취증가와 함께 전신골섭취계수가 증가된 경우 전신 골수전이에 의한 이차적 말초골수 확장을 고려해야 하며 이의 감별진단에 골수스캔이 유용한 검사이다.

• Journal of Gastric Cancer
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• 제14권1호
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• pp.54-57
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• 2014

Gastric cancer is a major cause of cancer-related mortality. At the time of diagnosis, majority of the patients usually have unresectable or metastatic disease. The most common sites of metastases are the liver and the peritoneum, but in the advanced stages, there may be metastases to any region of the body. Bone marrow is an important metastatic site for solid tumors, and the prognosis in such cases is poor. In gastric cancer cases, bone marrow metastasis is usually observed in younger patients and in those with poorly differentiated tumors. Prognosis is worsened owing to the poor histomorphology as well as the occurrence of pancytopenia. The effect of standard chemotherapy is unknown, as survival is limited to a few weeks. This report aimed to evaluate 5 gastric cancer patients with bone marrow metastases to emphasize the importance of this condition.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.118-125
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• 2010

Background and Purpose: Bone metastases rarely occur in patients with oral squamous cell carcinoma (OSCC), so the molecular mechanisms of bone metastasis of OSCC remains unclear. Studies with animal models allow progresses in understanding the molecular events for bone metastasis and provide new targets for therapy. So we tried to establish a murine model for bone metastasis of oral squamous cell carcinoma. Materials and Methods: Human OSCC cells (KB cell line) were xenografted to nude mice via direct inoculation into the tibial marrow. Mice with tibial tumors were sacrificed once a week, until seven weeks after the injection of human tumor cells. Growth of tibial tumors were observed by histology. Expression of TGF-$\beta$ and CXCR-4 in bone OSCC (experimental) and subcutaneous tumor (control) was also evaluated by immunohistochemical staining. Results: Bone OSCC was successfully induced by intra-tibial injection of KB cells. Tumor mass was developed in the marrow tissues of tibia and finally invade the endosteum of tibia. Immunohistochemical staining showed higher expression of TGF-$\beta$ in bone tumors than in subcutaneous tumors. Conclusion: A murine model of bone metastasis of OSCC was suggested that imitated the clinical findings of distant vascular metastasis. This bone tumor model should facilitate understanding of the molecular pathogenesis of OSCC bone metastasis, and aid in the developement of treatment strategies against OSCC bone metastasis.

• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.50-55
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• 2018

Gelatinous transformation of bone marrow is characterized by hypoplasia of fat cells with focal loss of hematopoietic cells and deposition of extracellular gelatinous substances. It is known to be associated with devastating underlying diseases that starve bone marrow. Here, we present a case of a patient whose magnetic resonance (MR) imaging findings of vertebral column were interpreted as metastasis or hematologic malignancy, however, the final diagnosis revealed a gelatinous transformation of bone marrow. This is the first report of gelatinous transformation of bone marrow without evidence of underlying devastating disease.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 2001년도 제40차 추계학술대회 및 총회
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• pp.34.4-34.4
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• 2001

• 한국임상수의학회지
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• 제40권3호
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• pp.203-208
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• 2023

A 13-year-old neutered male mixed-breed dog presented with generalized lymphadenopathy and erythematous cutaneous lesions in the ear pinnae. Fine-needle aspiration cytology of the lymph nodes revealed small to intermediate lymphocytes with a "hand mirror" configuration as the predominant cell type. Histopathological analysis of the lymph node showed an infiltrate of CD3-positive small lymphocytes compressing the follicles against the capsule owing to neoplastic cell expansion. Flow cytometric analysis revealed a homogeneous population of CD3+/CD4-/CD5+/CD8-/CD21+/CD34-/CD45- cells in both the peripheral blood and aspirated lymph nodes, which supports the diagnosis of T-zone lymphoma. Laboratory tests revealed lymphocytosis (14,144 cells/µL) in the peripheral blood. However, contrary to expectations, the bone marrow examination revealed no evidence of lymphocytic infiltration. T-zone lymphoma is an indolent lymphoma with a long survival period, and knowledge of its characteristics may affect disease staging and prognosis evaluation. Therefore, peripheral blood count as a sole screening tool for bone marrow metastasis should be used with caution.

• Investigative Magnetic Resonance Imaging
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• 제10권2호
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• pp.63-69
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• 2006

목적 : 고관절주위 대퇴골 및 절구뼈에 질병이 이환되었을 때는 골수 변성이나 부종이 발생하지만 연령에 따른 정상 골수전환이나 재전환을 감별하지 못하면 진단이 어려워진다. 이에 정상 골수 전환 양상을 연령군으로 분류하여 분석해 보았다. 대상 및 방법 : 자기공명영상에서 고관절 및 고관절주위 대퇴골와 절구뼈에 이상소견이 없고 혈청검사에서 골수이상을 초래할 만한 자가면역질환이나 혈액질환이 없는 144명 288개 고관절을 대상으로 하였다. T1강조영상으로 고관절주위 대퇴골 및 절구뼈의 골수를 관찰하였으며 골수 신호강도가 근육 신호강도에 가까우면 적색골수, 지방 신호강도에 가까우면 황색골수로 간주하였다. 대퇴골 골수는 머리, 목, 그리고 큰돌기, 작은돌기 그리고 돌기사이를 포함한 돌기 부위로 나누었고 절구뼈 골수는 황색골수 전환 절반이상과 이하로 나누었다. 연령은 10년 단위로 나누었고 또한 태생부터 10살까지는 1년 단위로 나누었다. 결과 : 절구뼈 절반이하 골수전환 되고, 대퇴골 머리 목 그리고 돌기가 골수전환 된 경우가 226례 78.5%, 대퇴골 머리와 돌기만 골수전환 된 경우는 44예 15.3% 였다. 연령별 골수전환 범위는 만2세전후부터 커지기 시작하여 만20세전후에서 끝나는 양상을 보였다. 결론 : 고관절주위 대퇴골 및 절구뼈의 연령별 정상 골수전환 양상을 이해함으로써 질병으로 인한 골수 변성이나 부종을 감별하고 드물지 않게 고관절 통증을 호소하는 전이암이나 백혈병 같은 골수대체성 질환을 진단 할 수 있을 것으로 사료된다.

• Korean Journal of Radiology
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• 제20권1호
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• pp.126-133
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• 2019

Objective: To compare the lumbar vertebral bone marrow fat-signal fractions obtained from six-echo modified Dixon sequence (6-echo m-Dixon) with those from single-voxel magnetic resonance spectroscopy (MRS) in patients with low back pain. Materials and Methods: Vertebral bone marrow fat-signal fractions were quantified by 6-echo m-Dixon (repetition time [TR] = 7.2 ms, echo time (TE) = 1.21 ms, echo spacing = 1.1 ms, total imaging time = 50 seconds) and single-voxel MRS measurements in 25 targets (23 normal bone marrows, two focal lesions) from 24 patients. The point-resolved spectroscopy sequence was used for localized single-voxel MRS (TR = 3000 ms, TE = 35 ms, total scan time = 1 minute 42 seconds). A 2 × 2 × 1.5 cm³ voxel was placed within the normal L2 or L3 vertebral body, or other lesions including a compression fracture or metastasis. The bone marrow fat spectrum was characterized on the basis of the magnitude of measurable fat peaks and a priori knowledge of the chemical structure of triglycerides. The imaging-based fat-signal fraction results were then compared to the MRS-based results. Results: There was a strong correlation between m-Dixon and MRS-based fat-signal fractions (slope = 0.86, R² = 0.88, p < 0.001). In Bland-Altman analysis, 92.0% (23/25) of the data points were within the limits of agreement. Bland-Altman plots revealed a slight but systematic error in the m-Dixon based fat-signal fraction, which showed a prevailing overestimation of small fat-signal fractions (< 20%) and underestimation of high fat-signal fractions (> 20%). Conclusion: Given its excellent agreement with single-voxel-MRS, 6-echo m-Dixon can be used for visual and quantitative evaluation of vertebral bone marrow fat in daily practice.