Abstract
The prevalence of radiation synovectomy practice is unknown. As new particulate radiopharmaceuticals offering many potential advantages are being developed, it seems prudent to appraise the extent, frequency and variation in radiation synovectomy practice. We have evaluated radiation synovectomy practice in Europe over the period 1991–1993 by means of a postal questionnaire. More than 2300 European members of the European Association of Nuclear Medicine were questioned about the number of treated patients and joints, disease prevalence in their patients and the use of radio-pharmaceuticals. Overall, 119/490 (24%) of centres replying to the survey practised radiation synovectomy during the 3 years. There were 13 450 different joint injections in 8578 patients. Rheumatoid arthritis was the most prevalent disease in patients treated (71%) and the most frequently treated joints were knee (46%) and finger joints (20%). Eight different radiopharmaceuticals were employed. Yttrium-90 colloids were most frequently and widely (100/119 centres) used, mainly employed for knee synovectomy but were also used to treat most appendicular joints. Erbium-169 colloid was almost exclusively used to treat finger joints (31/33 centres). Corticosteroid was routinely co-injected in 36/60 (60%) centres. Radiation synovectomy was widely practised throughout Europe during 1991–1993. There are variations in practice illustrated by the diversity of treated arthritides and injected joints and by the use and application of different radiopharmaceuticals.
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References
Deutsch E, Brodack JW, Deutsch KP. Radiation synovectomy revisited.Eur J Nucl Med 1993; 20: 1113–1127.
Sledge CB, Atcher RW, Shortkroff S, Anderson RJ, Bloomer WD, Hurson BJ. Intraarticular radiation synovectomy.Clin Orthop 1984; 182: 37–40.
Sledge CB, Zuckerman JD, Zalutsky MR, et al. Treatment of rheumatoid synovitis of the knee with intra-articular injection of dysprosium-165-ferric hydroxide macroaggregates.Arthritis Rheum 1986; 29: 153–159.
Davies MA, Chinol M. Radiopharmaceuticals for radiation synovectomy: evaluation of two yttrium-90 particulate agents.J Nucl Med 1989; 30: 1047–1055.
Mumper RJ, Mills BJA, Ryo UY, Jay M. Polymeric microspheres for radionuclide synovectomy containing neutron-activated holmium-166.J Nucl Med 1992; 33: 398–402.
Chinol M, Vallabhajosula S, Goldsmith SJ, et al. Chemistry and biological behaviour of samarium-153 and rhenium-186-labelled hydroxyapatite particles: potential radiopharmaceuticals for radiation synovectomy.J Nucl Med 1993; 34: 1536–1542.
Edmonds J, Smart R, Laurent P, et al. A comparative study of the safety and efficacy of dysprosium-165 hydroxide macroaggregate and yttrium-90 silicate colloid in radiation synovectomy — a multicentre double blind clinical trial.Br J Rheumatol 1994; 33: 947–953.
Clunie G, Lui D, Cullum I, Edwards JCW, Ell PJ. Samarium-153 particulate hydroxyapatite radiation synovectomy: biodistribution data for chronic knee synovitis.J Nucl Med 1995; 36: 51–57.
Jones G. Yttrium synovectomy: a meta analysis of the literature.Aust NZ J Med 1993; 23: 272–275.
Wright V, Moll JMH. Seronegative polyarthritis. Amsterdam: New Holland Biomedical Press, 1976.
Delbarre F, Menkes C, Le-Go A. Proof, by a double-blind study, of the efficacy of synoviorthesis by erbium-169 in rheumatoid arthritis of the fingers.C R Acad Sci Hebd Seances Aca Sci D 1977; 284: 1001–1004.
Ruotsi A, Hypen M, Rekonen A, Oka M. Erbium-169 versus triamcinolone hexacetonide in the treatment of rheumatoid finger joints.Ann Rheum Dis 1979; 38: 45–47.
Gumpel JM, Matthews SA, Fisher M. Synoviorthesis with erbium-169: a double-blind controlled comparison of erbium-169 with corticosteroid.Ann Rheum Dis 1979; 38: 341–343.
Gumpel JM, Beer TC, Crawley JCW, Farran HEA. Yttrium-90 in persistent synovitis of the knee — a single centre comparison. The retention and extra-articular spread of four Y-90 radiocolloids.Br J Radiol 1975; 48: 377–381.
Harbert JC. Radiocolloid joint therapy in joint diseases. In: Harbert JC, ed.Nuclear medicine therapy. New York: Thieme Medical; 1987: 169–186.
Derendorf H, Mollmann H, Gruner A, Haack D, Gyselby G. Pharmacokinetics and pharmacodynamics of glucocorticoid suspensions after intra-articuular administration.Clin Pharmacol Ther 1986; 39: 313–317.
Goode JD, Howey S. Effect of hydrocortisone on retention of Au-198.Ann Rheum Dis 1973; 32 (Suppl): 43–44.
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Clunie, G., Ell, P.J. A survey of radiation synovectomy in Europe, 1991–1993. Eur J Nucl Med 22, 970–976 (1995). https://doi.org/10.1007/BF00808407
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DOI: https://doi.org/10.1007/BF00808407