Radiation synovectomy

Various methods for incorporating radioactive rhenium into suitable particles have been introduced. The earliest example is the use of 186Re-labeled sulfur colloid for radiation synovectomy. Commercial preparations for this application have been available for many years (CIS, France, 1987 catalog). 186Re-sulfur colloid has been used for endocavi-tary irradiation of cystic craniopharyngiomas, where irradiation of surrounding tissue is a risk that must be avoided [155]. 

Hydroxyapatite particles can be used for radiation synovectomy by exploiting the strong binding of rhenium diphosphonate complexes to the surface of hydroxyapatite (vide supra). The same 186Re-HEDP preparations as for bone palliative therapy are used. When injected into joints, these particles (mean diameter 25 pm, maximum diameter 45 pm) remain within the joint to the extent of at least 95% for several days in arthritic rabbits and rats [156], More recently, microspheres have been labeled with 188Re for this purpose [156a,b],... 

Radiation synovectomy involves therapy of rheumatic synovitis in knees inflicted with rheumatoid arthritis. Treatment involves the use of Dy-165 FMHA (270 mCi) or Ho-166 FMHA(lOmCi). 

Shortkroff S, Mahmood A, Sledge C B et al 1992 Studies on holmium-166-labelled hydroxyapatite a new agent for radiation synovectomy. Journal of Nuclear Medicine 33 937... 

Chinol M, Vallabhajosula S, Goldsmith SJ, Klein MJ, Deutsch KF, Chinen LK, Brodack JW, Deutsch EA, Watson BA, Tofe AJ (1993) Chemistry and biological behavior of samarium-153 and rhenium-186-labeled hydroxylapatite particles Potential radiopharmaceuticals for radiation synovectomy. J Nucl... 

Chadzopoulos D, Badiavas K (2005) Complications in Y radiation synovectomy. Hell J Nucl Med 8 134 author reply 134... 

Yttrium ( °Y) silicate injection Radiation synovectomy agent... 

Disease activity was suppressed in an uncontrolled study in seven patients with RA treated with penicillamine initial doses of 5OO mg/day were increased to 1.8 g/day. Side-effects eventually demanded cessation of treatment.131 At doses up to 1,5 g/day, penicillamine resulted in significantly lowered sertrni IgG and IgM but not IgA levels at 5 and 6 months in patients with RA, suggesting that at least part of its immunosuppressive effect is at the cellular level, and may be specific for cells which produce certain classes of immunoglobulins. 32 Radiation synovectomy with intra-articular injections of yttrium-90 in 1+h rheumatoid knee joints benefited 50 /o of the patients, however the long-term danger... 

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