Use of indium chloride scintigraphy in patients with myelofibrosis

Various diagnostic modalities have been used to assess the degree and anatomic extent of erythroid elements in the marrow. Scintigrams of 111In-chloride uptake have been suggested for this purpose, but data regarding the association of 111In-chloride activity with erythroid elements are lacking. We compared the distribution of 111In-chloride with results from bone marrow biopsies, ferrokinetic data, liver and spleen histology, and the clinical status in 21 patients (18 with myelofibrosis and 3 with other hematological disorders). In 15 patients the sacral uptake of 111In-chloride correlated with marrow biopsy, ferrokinetic data, and clinical status. In five patients the scintigrams overestimated erythroid elements when compared with biopsy results but were consistent with ferrokinetic data and clinical status, suggesting that there is a limitation imposed 0.4 marrow biopsies because of sampling. Activity in the liver and spleen did not correlate with the presence of erythropoietic elements assessed histologically Indium-111-chloride scintigraphy appears to be a reliable means of assessing erythroid elements in bone marrow but not in the liver and spleen. (August 1974)