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The
Quantitative
and
B
the RE Cell
URING
rectilinear
distribution
B.
PAST
FEW
to delineate
scanning
of the
using
of
to
1 or
organs
of
the
which
accumulated
RAE
AND
several
2
The
millicuries
to
reticuloendothelial
the
of
one
of
Initially
the
many
nuclear
patients
is also
distribution
approach
of
and
its use
immediately
If one
uses
to establish
the
is
marrow,
restricted
radiocolloid
what
elements
is a rather
the
the
few
of
2-3
spatial
intra-
sort
was
the
other
the
spleen,
More
recently
for visualhalf-life
and
exposure
to
activity
rads
were
generally
to
and
dose.
results
in no
exposure
radiation
the
to
exposure
conveniently
bone
marrow
bone
marrow
8 hours)
use
organ.
organ
radioactive
it directly
than
this
by
technic
to
imaging
the
iron-52.3
Although
this
depicts
the functioning
is
produced
that
laboratories
the
to study
distribution
of the
constant
marrow.
In
quantitative
elements
skeleton
has
the
of
been
marrow
of the
in
have
a
cyclotron
cyclotron
facilities
the
RE
organ
cell
it is of basic
is in relation
importance
to the
hemato-
histologic
studies
relationship
of
of
the
normal
individuals
hematopoietic
and
marrow.
in
normal
removed
From
The
Division
of Nuclear
Medicine
University
of Washington
School of Medicine,
This work
supported
in part by U.S.P.H.S.
First submitted
January
2, 1969;
accepted
WIL
B. NELP,
M.D.:
Associate
Professor
of
Nuclear
Medicine.
RAE
ELLEN
BOWER,
B.S.:
Medicine.
276
this
have
become
available
with
a short
6 hour
lowered
the radiation
as
(half-life
a
the
after
available.
reticuloendothelial
which
to
of
liver
administered
may
the
administrated
ideal
insofar
52Fe
map
out
marrow
exposure
the
been
Using
about
5 times
more
gamma
photons
to increase
the speed
of imaging
as
resultant
image.
Thus
it is feasible
laboratories
diseases
affecting
to visualize
of intravenously
may
be more
erythron
poietic
there
medicine
with
possible
deposits
be used
of the
have
of man.
given
radiation
the patient
such
that
administration
of 10 millicuries
more
than
0.3 rad exposure
to the total
marrow
and
liver
and spleen.
This
represents
20 to 25 times
less
study
It
may
the
studies
primarily
colloids
labelled
with
technetium-99m
izing
the bone
marrow
organ.2
This isotope,
no beta
particle
emission,
has signfficantly
that
organ
of radioactivity
sulfur
2 millicuries
of ‘#{176}8Au
colloid
and
in the marrow
organ
which
can
well
as the information
content
technics
marrow
devises
minimize
majority
BOWER
( RE ) cells
system,
of Man
radioisotope
bone
amount
Erythron
Organ
ELLEN
functioning
colloids.
colloids.1
the
Marrow
YEARS
the
radioactive
gold-198
restricted
NELP
or camera
imaging
reticuloendothelial
injection
done
of
in the Bone
By WIL
THE
developed
venous
Distribution
have
Studies
also
shown
animals
a nearly
Departments
of Medicine
and
Washington.
Grant
TI-AM-5402.
for publication
May 8, 1969.
Medicine
and Radiology,
Head
Research
Technologist,
Division
in
identical
Radiology,
Seattle,
BLOOD,
VOL.
34,
No.
3
Division
of
of Nuclear
(SEPT.)
1969
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ERYTIThON
AND
THE
RE
277
CELL
Fig. 1.-Technetium-99m-sulfur colloid
photoscan
of an adult
male
depicting
tribution
marrow
organ.
restricted
heads.
also
seen.
is partially
concentration
distribution
quantitative
simultaneous
of
radiocolloid
spatial
distributions
causing
depression
of
clinical
experience
with
row
distribution
tribution
The
quantitative
of
the
two
and
cell
this
colloid
of the
photoscanning
to
(Fig.
1).
acquire
distribution
that
RE
and
is
and
spine
of
scan
activity.
In
shown
in
normal
man
very
similar
diseases
certain
questioned.6
also shows
described
for
additional
of the
activity
femurs
Pelvis
cell.4’5
have
may
bone
out due to high
in liver and spleen.
spine
and
skull
also
although
is comparable
erythron
done
to
RE
identity
Note
Midportion
marrow
studies
systems,
activity
which
the
imaging
99”Tc-sulfur
functioning
study
was
relationship
erythron
52Fe
marrow
pattern
of the
present
the
and
in the
cut
Cervical
show
dis-
normal
to proximal
humeral
are
the
of activity
be
information
cell
and
the
Our
a marthe dison
erythron
the
in
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278
NELP
Table
1.-Recovery
of Colloidal
% Recovered
Bone
in
Excised
Cold-198
% of
‘#{176}Fe
-m::
17.7
41.1
43.8
5.8
7.6
23.6
0.7
0.2
0.1
0.9
6.3
8.2
23.4
0.2
0.1
0.1
0.2
Femur
Tibia
Fibula
Patella
Feet
man.
A patient
compare
marrow
who
had
the localization
organ
of the
METhODS
The
patient
primary
was
lesion
extension,
was
pain,
root
invasion
tumor
tissue
year
old
obstruction
of
had
recurrent
resected
three
and
one-half
the
ureter
and
right
was
culture
was
restricted
the
was
to
sterile.
performed
region
of the
a temperature
the
patient
had
The
hematocrit
bilirubin,
albumin
of the
removal
particle
size
and
was
lower
40
body
Postoperatively
the
the
lower
were
skeleton
was
pelvis with the total sacrum
in the lower
extremities.
tumor
present
in
the
of the
earlier.
94
cells
per
and
was
normal.
cent
the
rectum.
coccyx
and
from
all bones
24 mg.
the
of the
had
tumor
occupied
The
of
polymorphonuclear
platelets
were
per
Twenty-four
removed
and
The
to
the
Because
local
cent.
hours
Serum
prior
surgical
lower
invaded
about
one-half
the
the
electro-
to
operative
(average
15 minutes
specimen.
This
extremities.
of
sacral
cells,
on
normal
received
500 uCi of colloidal
gold-198
50 uCi of 59Fe which
was preincubated
for
to permit
binding
of the 59Fe to transferrin.
cluded
the
was normal
was
carcinoma
years
patient
and
plasma
millimicrons)
5 ml. of the patient’s
with
globulin
opportunity
iron
throughout
extremities.
loss of bladder
control
from sacral
nerve
after
operative
exploration
indicated
all
pelvic
floor.0
of 38.5 C. Urinalysis
was normal
and a
34 per
cent,
the
white
blood
count
was
19,900
per
cu.mm.
with
a differential
count
showing
2 per cent lymphocytes
and 4 monocytes.
The
red
the peripheral
blood
smear.
The blood
urea nitrogen
lytes,
16.31
32.6
a unique
radioactive
and lower
who
surgically
1.58
3.16
MATERIALS
AND
man
a hemicorpectomy
Preoperatively
urine
a 52
and
pelvis
“Fe
89
7.14
1.04
1.34
3.82
.03
.01
.01
.04
.66
.09
.12
.38
.02
.01
.01
.01
provided
of radiocolloid
surgically
exised
Dose
-:,o
Specimen
a hemicorpectomy
Injected
““Au
#{189}
Specimen
Total
BOWER
Iron-59
5keleton
Au
Sacrum
Ilium
Ischium
Pubis
and
AND
in-
Muscle
nerve
marrow
mass
roots
of
the
and
fourth
and fifth sacral
of the marrow
vertebrae.
No other
tumor
was present
in the skeleton.
Histologic
sections
from the ilium and femur
were interpreted
as normal.
The
distribution
of colloidal
gold and 59Fe within
the marrow
was determined
as follows.
The sacrum
was cut into two equal
sections
along
the posterior
midline.
The pelvis
was
separated
and
the
right
ischium,
pubis
and
ileum
were
saved
for sectioning.
All bones
of
the right lower extremity
were likewise
removed
for sectioning.
The bones of the left half
of the skeleton
were
not processed
for radioactive
counting
but were
sectioned
longitudinally
to
examine
essentially
the
The
bones
#{176}The decision
with
the
patient,
ments
of
Physical
freely
sequent
gave his
analysis
the
gross
same as the
of the right
to
perform
his
wife
Medicine
informed
of the
appearance
contralateral
side
(with
a
and
the
hemicorpectomy
referring
and
consent
marrow
of
physician
Rehabilitation
for the
organ
marrow
bones.
the exception
and
of
which
the
was
reached
and
after
Psychiatry.
appeared
bones
of
normal
the
after
extensive
consultation
with
Prior
injection
of the
radioactive
of the excised
specimen.
to
surgery
materials
feet
and
and
the
discussion
the
Depart-
the
patient
and
sub-
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ERYTHRON
THE
AND
RE
279
CELL
Distribution
of
Erythron
and
RES:
Ilium-
Mon
Fe59
Aut98
II
4
I:
2
0
4
6
8
0
2
4
6
8 20
Segment
number
Fig. 2.-Relative
Distribution
concentrations
of both in each
of ‘98Au-colloid
of the 37 small
22
24
26
28
30
32
and 59Fe in the ilium.
segments.
See text for
34
36
Note similar
details.
patella)
were
cut
into
numerous
sections
(sacrum
19, ischium
14, pubis
10, ilium
37,
femur
51, tibia 19, fibula 6) and the concentration
of 198Au and 59Fe in each small segment
was measured
with a sodium
iodide
scintillation
detector
and
a gamma
ray
spectrometer.
The amount
of radioactivity
in each
segment
was compared
to a standard
fabricated
in a
similar
geometric
configuration
so that the per cent of the injected
dose and the per cent
of the
recovered
dose
of both
198Au
and 59Fe could
be calculated
for each bone segment.
RESULTS
In
the
colloid
right
and
both
half
of the
16.31
halves
per
of the
excised
cent
the
of
1.58
per
cent
59Fe
was
recovered.
injected
‘98Au
Assuming
bid,
twice
the above
amounts
of the 59Fe were
contained
or 3.16 per
in the entire
cent of the ‘#{176}8Au
and 32.6 per cent
specimen.
Table
1 lists the amount
of the
bone
dose
per
cent
columns
colloid
was
in the
sacrum,
1 and 2, one can
in the RE cells and
skeleton.
Analysis
of small
ity of the distribution
relative
distribution
The
in each
per
cent
and
also
cent of the dose
recovered
example,
of the radioactive
of
per
was
of the
‘98Au
isotopes
the
both
in the
dose
individual
ilium,
bones
the
and
content
etc.
emphasized
amount
iron
col-
of the
skeleton
(columns
in the skeleton
18.2
distribution
was similar
colloid
and the 59Fe.
in the 37 segments
(considering
the
radioactive
the relative
quantitative
the 59Fe in the erythron
of
ileal
cent
the
the excised
recovered
see
segments
of
the
41.1
lists
from
‘98Au
of
that
equal
bone
as a per
1 and 2). For
amounts
of the
accumulated
injected
skeleton
skeleton
injected
By
comparing
of the
throughout
the
‘98Au
the
similar-
Figure
2 shows
the
of the right
ilium.
of
radioactivity
re-
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280
Distribution
of Erythron
and RES
8
o
-
NELP
Man
AND
BOWER
20
15
tO
5)
5)
‘-I
2
4
6
8
0
24
6
0
2
2
4
6
8
0
12
4
6
q)
Fe59
o\0
-
4
8
2
16
20
24
Segment
Fig.
sacrum
are
3.-Relative
and femurs.
the
essentially
Distribution
Relative
same.
See
covered
in
for both
patterns
198Au
(RES)
were
seen for
and
femur
the
ilium
(Fig.
Figure
One
This
in
normal
the
of the
see
the
44
48
and
each
59Fe
in
the
segment
of
pubis,
the
ischium,
various
bones
details.
cent)
quantitative
that
pattern
in
segment
each
Similarly
for the
spatial
cent
of the
was
strikingly
similar
identical
distribution
pubis,
ischium,
sacrum
one
to
see
activity
functioning
colloid
the
was
seen
in marrow
activity
only
in
mar-
is depicted
same
(Fig.
in the
marrow
activity
decreased
cent
of the activity
present
of that
expects
of the
of 198Au
was essentially
marrow
trochanter.
Distally,
less than
10 per
is characteristic
(Fig.
distribution
instance
the distribution
59Fe (the
erythron)
38 per
adult
femur
40
and
59Fe
(erythron).
the segments
analyzed
femur
above
the lesser
the lower
third contained
femur.
for
100 per
as
36
3).
4 depicts
can
32
of 198Au-colloid
concentrations
in
text
row in the femur.
In this
(RES).
The distribution
3).
28
number
proximal
so that
in the
photoscans,
the
upper
where
one-third
1).
DIscussIoN
These
the
studies
erythron
confirm
in the
marrow
and
same
simultaneous
photoscans
type of relationship.46
tion
small
of the
bones
of
the
two
of the
recovered
the
components
feet.
In
198Au-colloid
identical
organ
spatial
of
of 52Fe
A minor
this
man.
distribution
Similar
of
studies
the
cell
and
animals
and 99#{176}’Tc-colboid in man
indicated
this
discrepancy
in the quantitative
distribu-
(RES
and
erythron)
might
be
subject
the foot bones
contained
and
RE
in normal
only
0.2
per
cent
of
the
present
0.9
recovered
in
per
the
cent
59Fe.
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ERYTHRON
AND
THE
281
CELL
BE
Distribution
of Functioning
Marrow:
Femur
-
Mon
0
C-)
8%
E
1%
Fig.
4.-Distribution
activity
In
is in the
normal
rabbits
than iron.5
The data
59Fe in the
space
in
this
of the
proximal
the
man
by
55
also
per
functioning
cent
of
In
for
and
this
contained
estimation
marrow
study
adult
femur.
Majority
of
slightly
more
colboid
of the initial
deposition
of intravenous
to early
studies
of the bone
marrow
of
functioning
the
pelvis
and
lower
space
and
about
40
that
total
in the
details.
consistently
calculated
the
marrow.
text
indication
According
Mechanik7’8
been
marrow
See
tarsals
also provides
an
marrow
of man.
space,#{176}it has
about
functioning
one-third.
33
per
cent
of
59Fe
marrow
within
limbs
contain
per
cent
was
recovered
59Fe
in
of
the
in
this
is
not
space.
After
an
certain
possibly
by
intravenous
how
70 per
Donohue
59Fe
in
(particularly
the
of
the dose
or greater.
cent
and
was
injection
of
much
associates1#{176} indicated
5 to 12 hours
in rats
and
rabbits)
activity
was
recovered
transferred
was
in
it,
of the
marrow,
cent
colboid
localized
in the
mates
of
the
marrow
this
the
3.2 per
functioning
was
that
49
following
some
total
total
distribution
judged
by photoscanning
from the marrow
of young
of the
man
it
in the erythron
(rat,
rabbit
and
to 84 per
injection.
59Fe
had
cent
Still
returned
but it is
monkey)
of injected
at this time
to the
blood
functioning
of the total
to
In addition
cent
of the
bound
deposited
in animals
skeleton
labelled
to erythrocytes.
If the
was
approximately
40 per cent
59Fe
transferrin
is initially
Studies
would
marrow
198Au
thus
erythron
and
during
was recovered
by calculation
marrow
of
studies,
rabbits.5
marrow
mass in the present
subject
and 33 per cent
of the 59Fe radioindicate
that
about
84 per cent of the
organ.
This
intravenously
is similar
the
first
in approximately
8 per cent
figure
11.5
of
agrees
injected
to the
24
hours.
40 per
injected
with
esti-
198Au-colloid
per
cent
as
recovered
SUMMARY
Studies
of the
quantitative
distribution
of the
RES
and
the
erythron
in the
From www.bloodjournal.org by guest on June 16, 2017. For personal use only.
282
NELP
bone
marrow
old male
59Fe were
of the
pelvis
undergoing
injected
and
lower
extremities
hemicorpectomy.
24 hours
prior
were
performed
198Au colloid
disarticulation
to
AND
BOWER
in a 52 year
and
transferrmn
of the
lower
bound
skeleton.
Thirty-three
per
cent
of the injected
59Fe and
3.2 per
cent
of the
198Au-colloid
was recovered
in the excised
skeleton.
By calculation
mately
84 per cent
of the injected
59Fe and 8 per cent
of the ‘98Au
posited
activity
of them.
in the total
body
marrow.
was essentially
the same
The results
support
the
tative
distribution
of the
man
is essentially
identical
row
using
RES
radiocolloids
ropoietic
The
spatial
distribution
of 198Au and 59Fe
in each
bone
and in multiple
small
sections
concept
that in normal
situations
the quanti-
and
and
does
injected
approxiwas de-
the
that
erythron
in the
radioisotope
depict
the
bone
marrow
photoscanning
quantitative
organ
of
distribution
the
of
mar-
of the
eryth-
marrow.
SUMMARIO
IN
INTERLINGUA
distribution
quantitative
del systema
reticuloendothelial
e del erythron
in le
medulla
ossee
del pelve
e del extremitates
inferior
esseva
effectuate
in sin masculo
de 52
annos
de etate
subjicite
a hemicorpectomia.
Colloide
a 198Au e 59Fe ligate
a transferrina
esseva
injicite
24 horas
ante le disarticulation
del skeleto
inferior.
Trenta-tres
pro cento
del
injicite
59Fe e 3,2 pro cento
del injicite
colloide
a lO8Au
esseva
retrovate
in Ic excidite
skeleto.
Esseva
calculate
que approximativemente
84 pro
cento
del
injicite
59Fe e 8 pro
cento
del 198Au esseva
deponite
in le medulla
ossee total. Le distribution
spatial
dcl activiStudios
tate
del
de
198Au
sectiones
e de
ossee.
del
quantitative
del
homine
le
uso
es
de
59Fe
esseva
Le resultatos
systema
essentialinente
mesme
le conception
reticuloendothelial
e del
essentialmente
radiocolloides
le
supporta
identic
representa
e
que
in
cata
photoscrutinage
le distribution
osso
e in
multiple
que in situationes
normal
erythron
in le organo
de
radioisotopic
quantitative
del
del
medulla
micre
le distribution
medulla
ossee
medulla
con
erythropoietic.
ACKNOWLEDGMENTS
We
Dr.
wish
to
Donald
acknowledge
Dr.
Resident,
Rogers,
Loren
C. Winterschied,
Department
Associate
of Pathology,
for their
Professor
of Surgery
assistance
in these
and
studies.
REFERENCES
1. Kniseley,
R. M.:
The bone marrow.
In Wagner,
H. N., Jr. (Ed.):
Principles
of
Nuclear
Medicine,
Vol.
I.
Philadelphia,
Saunders,
1968.
Vano,
Y., and
distribution
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From www.bloodjournal.org by guest on June 16, 2017. For personal use only.
1969 34: 276-282
The Quantitative Distribution of the Erythron and the RE Cell in the Bone
Marrow Organ of Man
WIL B. NELP and RAE ELLEN BOWER
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