Which radioisotopes are used to evaluate sites of erythropoiesis?

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Tracking where erythropoiesis happens relies on following how iron gets into developing red cells, since iron is essential for heme synthesis in new erythrocytes produced in the marrow. Iron radioisotopes such as iron-59 (and iron-52) are taken up by maturing erythroblasts in the bone marrow, allowing measurement of marrow activity and localization of sites actively making RBCs. Technetium-99m can be used to label red blood cells and also to image bone marrow activity, helping visualize erythropoietic regions by showing where RBC production and turnover are most active.

Other isotopes listed—tritium and carbon-14 label organic molecules but aren’t used to image or quantify marrow erythropoiesis; phosphorus-32 and sulfur-35 label nucleic acids and proteins but don’t provide specific marrow erythropoiesis imaging; iodine-131 targets the thyroid. Thus, combining iron isotopes with technetium-99m best addresses evaluating sites of erythropoiesis.