• Title/Summary/Keyword: Radiation synovectomy

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Radiation Synovectomy: when, which disease, and which joint (방사성 동위원소 활액막절제술의 임상응용)

  • Choi, Chang-Woon
    • 대한핵의학회:학술대회논문집
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    • 1999.05a
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    • pp.196-199
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    • 1999
  • Radiation synovetomy with various radiopharmaceuticals has been used to alleviate pain and swelling of rheumatoid arthritis and related joint diseases for more than 40 years. It is an attractive alternative to the surgical synovectomy for the management of the various joint diseases. Recently, the development of new radiopharmaceuticals labeled with $^{90}Y,\;^{32}P,\;^{186}Re,\;^{188}Re,\;^{153}Sm,\;^{165}Dy$ and $^{166}Ho$, for the effective management of synovial inflammation and related arthritic problems are gaining attention. In this article the general concepts and the clinical application of radiation synovectomy are reviewed.

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Preclinicnl Trial of Radiation Synovectomy with Ho-166 (Ho-166 활액막절제술의 임상시험)

  • Lee, Jong-Doo
    • 대한핵의학회:학술대회논문집
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    • 1999.05a
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    • pp.200-204
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    • 1999
  • Rheumatoid arthritis (RA) is o chronic inflammatory disease of joints with proliferation of synovial epithelial tissue. Therapeutic approach of the RA consists of pharmacological and surgical interventions. Synovectomy is indicated in patients with progressive inflammatory signs and symptoms intractable to medical treatment including local intracavitary steroid injection. Recently, local injection of radionuclides which emit high energy beta rays are labeled with chemical compounds such as $^{90}Y,\;^{165}Dy-ferric$ hydroxide macroaggregate and have been introduced as an alternative therapeutic modality to surgical synovectomy. Holmium-166 is one of beta emitter and Ho-166-chitosan complex was developed for radiation synovectomy. Preclinical trial is on-going at our hospital using Ho-166-chitosan. The procedure and methods of preclinical trial are discussed.

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DA-7911, rhenium-188 ($Re^{188}$) tin colloid. as a strong candidate agent for radiation synovectomy

  • Shin, Chang-Yell;Jung, Mi-Young;Lee, In-Ki;Son, Mi-Won;Kim, Soon-Hoe;Kim, Won-Bae
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.252-252
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    • 2002
  • Radiation synovectomy is an useful alternative treatment to rheumatoid arthritis and Re$\^$188/ is suggested as an ideal radiopharmaceutical agents because beta ray (2.1 MeV) emitted from Re$\^$188/ is appropriate for synovial cell ablation and gamma ray (155 KeV) is ideal for dosimetry. Its' ideal particle size (2-5 mm) was achieved by conjugation with tin-colloid, In this study, we investigated the toxicity, stability and biodistribution to evaluate the suitability of DA-7911 as a synovectomy agent. (omitted)

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Initial experience with intra-articular 188Re-tin colloid as a "radiation synovectomy" agent in various joints

  • Shinto, Ajit S;Indira, VU;Kamaleshwaran, KK;Banka, Vinay Kumar;Aswathy, KK;Thirumalaisamy, SG;Rajamani, V;Mallia, Madhav;Banerjee, Sharmila
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.1 no.2
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    • pp.109-117
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    • 2015
  • Radiation synovectomy has been proposed as a promising palliative therapy for recurrent joint effusions for the last two or three decades. Ionizing radiations emitted by intrarticularly administered radiolabelled colloids. The aim of this study was to assess the effectiveness of radiation synovectomy (RSV) using $^{188}Re$-tin colloid in the treatment of recurrent joint effusions and chronic synovitis of knee joints. Three phase bone scan was acquired for the concerned joint prior to radiosynovectomy. $^{188}Re$-tin colloid was prepared as per the reported protocol. 9 patients, diagnosed with rheumatoid arthritis and suffering from chronic resistant synovitis of the knee, ankle or elbow joints were administered the radiopharmaceuticals, checked for radiochemical purity >95% by intraarticular route. A whole body scan was acquired 2 h post-radiosynovectomy. In all the 9 treatments, no leakage to non-target organs was visible in the whole body scan. Static scans of the joint revealed complete retention of $^{188}Re$-tin colloid in the joints post administration of the agent. Clinically all patients exhibited a complete or partial response. RSV with $^{188}Re$-tin colloid was safe and effective in patients with chronic synovitis of rheumatoid origin.

Diffuse Pigmented Villonodular Synovitis of the Knee: Case Report (무릎 관절의 미만형 색소 융모 활액막염: 증례 보고)

  • Choi, Sang-Gyu
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.278-282
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    • 2007
  • Purpose: Diffuse pigmented villonodular synovitis (PVNS) is an uncommon aggressive synovial proliferative disorder of unknown etiology affecting the joint linings. Though a histologically benign inflammatory process, because of its aggressive growth with bone destruction or recurrence, it is frequently suggested to occur as a low malignant neoplasm. Optimal treatment is surgery, but the local recurrence rate after radical synovectomy for diffuse PVNS is relatively high due to the infiltrative growth pattern. External beam radiotherapy with moderate doses or intra-articular instillation of radioactive isotopes may improve the likelihood of local control and long-term function in patients with incompletely resected or recurrent diffuse PVNS. I report one case of diffuse PVNS of the right knee joint treated with arthroscopic synovectomy and external beam radiotherapy is presented.

DA-7911, $^{188}Rhenium-tin$ Colloid, as a New Therapeutic Agent of Rheumatoid Arthritis

  • Shin, Chang-Yell;Son, Miwon;Ko, Jun-Il;Jung, Mi-Young;Lee, In-Ki;Kim, Soon-Hoe;Kim, Won-Bae;Jeong, Jae-Min;Song, Yeong-Wook
    • Archives of Pharmacal Research
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    • v.26 no.2
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    • pp.168-172
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    • 2003
  • Radiation synovectomy is one of the most useful methods for treating patients with refractory synovitis because of its convenience, long-term effects, repeatability and the avoidance of surgery. In this study, we investigated the toxicity, stability and biodistribution of a rhenium-188 ($^{188}$Re)-tin colloid to evaluate its suitability as a synovectomy agent. Twenty four hours after injecting the $^{188}$Re-tin colloids (74 KBq/0.1 mL) into the tail vein of ICR mice, most of the $^{188}$Retin colloidal particles was found in the lungs. In addition, there were no particle size changes at either room temperature or at $37^{\circ}C$ after injecting the $^{188}$Re-tin colloids in human plasma and synovial fluid. In vitro stability tests showed that the $^{188}$Re-tin colloid remained in a colloidal form without a critical size variation over a 2-day period. We investigated the leakage of $^{188}$Retin colloids from the intraarticular injection site with gamma counting in New Zealand white rabbits. The $^{188}$Re-tin colloids (55.5 MBq/0.15 mL) were injected at the cavum articular and the mean retention percentage of the $^{188}$Re-tin colloid was 98.7% for 1 day at the injection site, which suggests that there was neither change in the particle size nor leakage at the injection sites. In the biodistribution study with the SD rats, the liver showed the highest radioactivity (0.0427% ID/organ) except for the injected knees (99.49%). In the SD rats, mild toxicities including the skin or a synovium inflammation were observed as a result of a radioactivity of 15 mCi/kg at the intraarticular injection site. However, there was no systemic toxicity. In the Ovalbumin (OVA)-induced arthritic rabbits, the $^{188}$Re-tin colloid improved the macroscopic, the histological score and reduced the knee joint diameter when compared to the arthritic control. In conclusion, a $^{188}$Re-tin-colloid is considered as a strong candidate for radiation synovectomy with a superior efficacy and safety.

Combined Arthroscopic Gross Total Synovectomy and Radiotherapy for Diffuse Pigmented Villonodular Synovitis of the Knee: A Report of 2 Cases (무릎관절의 미만형 색소 융모 결절성 활액막염에서 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료: 증례보고)

  • Chang, Sei-Kyung;Kim, Jae-Hwa;Ha, Doo-Hoe;Kang, Hae-Youn;Chong, So-Young;Shin, Hyun-Soo
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.201-206
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    • 2006
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.