Norm of Bone Marrow Scan
Even concentration of the radionuclide throughout the reticuloendothelial system, red blood cells, and bone marrow.
Usage of Bone Marrow Scan
Assists in the diagnosis of defects in bone marrow or bone marrow depression after chemotherapy or radiation, in the differential determinations of myeloproliferative disorders, and with increased pulmonary uptake consideration of Pneumocystis carinii pneumonia. Differentiates acute from chronic hemolysis and bone infarction from osteomyelitis in sickle cell disease. Aids in the selection of bone marrow biopsy sites and in the staging of Hodgkin's disease, lymphomas, and metastatic diseases of the bone marrow. Assists in evaluation of hyperplasia of the bone marrow associated with chronic hemolytic anemia and polycythemia vera.
Description of Bone Marrow Scan
The bone marrow scan is a nuclear medicine study in which the radionuclide indium chloride is administered intravenously and followed by radiographic imaging of the entire body. This scan can be nonspecific in conditions of diffuse disease such as osteomyelitis and tumor. However, areas of increased vascularity and hyperproliferation of bone marrow can be demonstrated much earlier with a bone marrow scan than by conventional radiography.
Professional Considerations of Bone Marrow Scan
Consent form IS required.
Hematoma at injection site.
During pregnancy, risks of cumulative radiation exposure to the fetus from this and other previous or future imaging studies must be weighed against the benefits of the procedure. Although formal limits for client exposure are relative to this risk-benefit comparison, the United States Nuclear Regulatory Commission requires that the cumulative dose equivalent to an embryo/ fetus from occupational exposure not exceed 0.5 rem (5 mSv). Radiation dose to the fetus is proportional to the distance of the anatomy studied from the abdomen and decreases as pregnancy progresses. For pregnant clients, consult the radiologist/radiology department to obtain estimated fetal radiation exposure from this procedure.
Pregnancy or during breast-feeding.
- The client should void before the procedure.
- Have emergency equipment readily available.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
- The radionuclide indium chloride is administered intravenously.
- Whole-body imaging is planned for 48 hours after intravenous injection.
- If the radioisotope 99mTc-sulfur colloid is given, the scan can be completed 1 hour after the intravenous injection.
Client and Family Teaching
- Notify the physician for previous reaction to radionuclide.
- An IV tube may be inserted for the scan and removed after the scan is complete. Some technicians may use direct venipuncture for the injection.
- Results are normally available within 24 hours.
- In women who are breast-feeding, formula should be substituted for breast milk for 1 or more days after the procedure.
Factors That Affect Results
- None found.
- Health care professionals working in a nuclear medicine area must follow federal standards set by the Nuclear Regulatory Commission. These standards include precautions for handling the radioactive material and monitoring of potential radiation exposure.
- Indium scan is positive in 20%–30% of clients after other imaging methods failed to detect metastasis.