HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ofluoglu, S. Articles by Pirich, C. Search for Related Content PubMed PubMed Citation Articles by Ofluoglu, S. Articles by Pirich, C.

Radiation Synovectomy with ¹⁶⁶Ho-Ferric Hydroxide: A First Experience

¹ Department of Nuclear Medicine, University of Vienna, Vienna, Austria
² Department of Orthopedics, University of Vienna, Vienna, Austria
³ Department of Biomedical Engineering and Physics and Ludwig Boltzmann Institute of Nuclear Medicine, Vienna, Austria
⁴ Department of Nuclear Medicine, General Hospital of Wiener Neustadt, Wiener Neustadt, Austria

ABSTRACT

Radiation synovectomy (RS) is indicated when conventional pharmacologic treatment of chronic synovitis has not relieved its symptoms. The use of radionuclides that are bound to ferric hydroxide (FH) particles has been shown to be effective and safe for this procedure. ¹⁶⁶Ho-FH macroaggregates offer promising properties for RS but there is a lack of clinical data. We investigated the efficacy and safety of ¹⁶⁶Ho-FH in a prospective clinical trial in patients suffering from chronic synovitis. Methods: Twenty-four intraarticular injections were performed in 22 patients receiving a mean activity of 1.11 GBq (range, 0.77–1.24 GBq) ¹⁶⁶Ho-FH. Blood activity measurements and monitoring of activity distribution were performed by whole-body gamma-camera imaging for control of leakage 3 and 24 h after injection of ¹⁶⁶Ho-FH. The patients were evaluated clinically before RS, 1 wk and 1 mo after the treatment, and thereafter in 3-mo intervals by assessing joint effusion, pannus, local pain, range of motion, and the patient’s satisfaction. Results: In 18 of 24 treatments, no leakage to nontarget organs was visible, whereas small amounts of activity could be detected in the local inguinal lymph nodes in 6 patients and to the lungs and to the liver in 1 patient (<0.1%). In all cases leakage to the lymph nodes was <1%. Leakage to the blood was negligible. Clinically, 17 patients (71%) exhibited a complete or partial response. Conclusion: RS with ¹⁶⁶Ho-FH was safe and effective in patients with chronic synovitis of different origin. Controlled clinical trials are necessary to evaluate the therapeutic efficacy and safety compared with the treatment with other radionuclides and glucocorticosteroids.

Key Words: radiation synovectomy • ¹⁶⁶Ho-ferric hydroxide • leakage