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Radiation synovectomy

Ashwani Sood, Aman Sharma, Devendra Kumar Chouhan, Kirti Gupta, Rahul Parghane, Jaya Shukla, Bhagwant Rai Mittal
The authors in this case report highlight the poor outcome of radiation synovectomy (RSV) for repeated knee joint effusion in a patient with histopathologically proven nonspecific arthritis. There was partial response initially following RSV but later follow-up showed recurrence in joint effusion with limited and painful mobility of the knee joint. Subsequent surgical synovectomy and histopathological examination showed it to be tubercular in origin. Thus in a country endemic for tuberculosis, an alternative infective etiology should also be kept in mind before subjecting the patient to RSV...
September 2016: World Journal of Nuclear Medicine
I Hartig, I Matveeva, M Braun
Intra-articular radiation synovectomy is an established and well documented therapy in rheumatology. A rare side effect is necrosis of surrounding tissue caused by leakage of the radionuclide.We describe the case of a 34-year old patient with rheumatoid arthritis who developed skin necrosis 4 weeks after an intra-articular radiation synovectomy of the left wrist. When these lesions are recognized early surgical therapy or hyperbaric oxygen therapy can be initiated.
September 2, 2016: Zeitschrift Für Rheumatologie
A Rajeswari, K V Vimalnath, H D Sarma, Priyalata Shetty, Shahiralm Khan Mohammed, Jitendra Nuwad, Sudipta Chakraborty, Ashutosh Dash
In the present article we describe a systematic approach pursued for the synthesis of (32)P-labeled hydroxyapatite (HA) microparticles (1-10µm size range) using no carrier added (NCA) (32)P produced in a nuclear reactor and animal evaluation of its utility as an expected viable radiopharmaceutical for the treatment of pain intensive arthrosis. NCA (32)P was produced via the (32)S(n,p)(32)P route in nuclear reactor with high radionuclidic purity (99.95±0.01%, n=5). Phosphorus-32-labeled hydroxyapatite microparticles (1-10µm size range) were synthesized with high radiochemical purity (99...
October 2016: Applied Radiation and Isotopes
Lidia García-Colmenero, Gemma Martin-Ezquerra, Jordi Monfort, Ramon M Pujol
Development of persistent deep cutaneous ulceration is a rare and serious complication of radiosynovectomy, an extended procedure used in the treatment of chronic synovitis. Cutaneous radiation necrosis is a rare complication of synovectomy, probably as a result of radiocolloid para-articular injection. This rare phenomenon should be suspected when an ulcer adjacent to an articulation appears several days or even months after a radiation synovectomy. It can turn into a challenging diagnosis for rheumatologists, orthopaedists and dermatologists, especially in those cases with a late development of the skin lesions...
July 21, 2016: International Wound Journal
Joanna Zalewska, Małgorzata Węgierska, Tacjana Barczyńska, Marzena Waszczak, Paweł Żuchowski, Sławomir Jeka
OBJECTIVES: Hypertrophic and exudative synovitis of the knee is one of the earliest symptoms in rheumatic diseases. In the case of pharmacotherapy failure, other methods which directly remove the inflamed synovial membrane are used - synovectomies. Radiosynovectomy (RSV) is the radiopharmaceutical application of colloidal solution to joint cavities. In this study, the authors assessed the efficacy of knee radiosynovectomy with yttrium-90 (Y-90) in several groups of patients divided into certain rheumatic diseases...
2016: Reumatologia
Andras Polyak, Lívia Naszályi Nagy, Eszter Drotár, Gabriella Dabasi, Róbert P Jóba, Zita Pöstényi, Renata Mikolajczak, Attila Bóta, Lajos Balogh
The present article describes the preparation of β-emitter lutetium-177-labeled zirconia colloid and its preliminary physicochemical and biological evaluation of suitability for local radionuclide therapy. The new (177)Lu-labeled therapeutic radiopharmaceutical candidate was based on the synthesis mode of a previously described zirconia nanoparticle system. The size and shape of the developed radiopharmaceutical compound were observed through a scanning electron microscope and dynamic light scattering methods...
December 2015: Cancer Biotherapy & Radiopharmaceuticals
Mira Merashli, Adil Al-Nahhas, Ali S Jawad
No abstract text is available yet for this article.
January 2016: Nuclear Medicine Communications
Koramadai Karuppusamy Kamaleshwaran, Venkataraman Rajamani, Boopathi Krishnan, Madhav Mallia, Radhakrishnan Kalarikal, Vyshakh Mohanan, Ajit Sugunan Shinto
Rheumatoid arthritis (RA) is a chronic disease that is mainly characterized by the asymmetric erosive synovitis, particularly affecting peripheral joints. Radiation synovectomy or radiosynovectomy (RSV), also known as radiosynoviorthesis was first described in 1950's as an adjuvant treatment for RA. RSV is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. As a generator-produced β-emitting radionuclide, the importance of rhenium-188 (Re-188) for radionuclide therapy is increasing rapidly...
September 2015: World Journal of Nuclear Medicine
A Isart, P E Gelber, M Besalduch, X Pelfort, J I Erquicia, M Tey-Pons, J C Monllau
INTRODUCTION: Pigmented villonodular synovitis (PVS) is a synovial proliferation disorder of uncertain aetiology, with some controversy as regards its proper treatment. The purpose of the study was to evaluate the functional outcome and recurrence rate in a series of patients diagnosed with both the diffuse and the localised type of PVS and treated by arthroscopic resection. MATERIAL AND METHODS: Twenty-four patients diagnosed with PVS were retrospectively assessed...
November 2015: Revista Española de Cirugía Ortopédica y Traumatología
Imtiaz Ahmed Abbasi
For the treatment of skeletal metastasis, a therapeutic radionuclide tagged with a bone seeking ligand is required, while for radiation synovectomy (RS), a therapeutic radionuclide irreversibly attached to pre-formed particles of appropriate size is required. Radio lanthanides are mostly therapeutic, and ligands containing phosphate groups are predominantly bone seekers. Exploiting these facts, number of new therapeutic radiopharmaceuticals could be developed. Labeling of four phosphate containing materials was pursued in the present study...
May 2015: World Journal of Nuclear Medicine
Bo Yang, Duan Liu, Jin Lin, Jin Jin, Xi-sheng Weng, Wen-wei Qian, Jun Qian
OBJECTIVE: To compare the roles of open synovectomy and arthroscopic synovectomy in the treatment of diffuse pigmented villonodular synovitis (D-PVNS). METHODS: Forty-seven patients suffered from D-PVNS of knee joint who underwent surgical treatment with complete follow-up data from March 1994 to October 2013 were retrospectively analyzed. All patients were divided into two groups as open synovectomy group (n=17) and arthroscopic synovectomy group (n=30) according to the surgical procedure...
April 2015: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Tapas Das, Sharmila Banerjee
Lutetium-177 has been widely discussed as a radioisotope of choice for targeted radionuclide therapy. The simultaneous emission of imageable gamma photons [208 keV (11%) and 113 keV (6.4%)] along with particulate β(-) emission [β(max) = 497 keV] makes it a theranostically desirable radioisotope. In the present article, the possibility of using two 177Lu-based agents viz. 177Lu-EDTMP and 177Lu-DOTATATE for theranostic applications in metastatic bone pain palliation (MBPP) and peptide receptor radionuclide therapy (PRRT), have been explored...
2016: Current Radiopharmaceuticals
Liepe Knut
Radiosynovectomy is a well-established therapy in arthritis and involves an intra-articular injection of small radioactive particles to treat a synovitis. In Europe, frequent indications are rheumatoid and poly-arthritis. Especially in Germany radiosynovectomy is the second common therapy in Nuclear Medicine with about 40,000-60,000 treated joints per year. In Spain, USA, Turkey, Argentines and Philippines the therapy is more use in hemophilic arthritis with excellent results. Especially in developing countries with low availability of clotting factors, the radiosynovectomy represent a cost effective therapeutic option for repeated bleedings in hemophilic arthropathy...
January 2015: World Journal of Nuclear Medicine
K V Vimalnath, Sudipta Chakraborty, A Rajeswari, H D Sarma, Jitendra Nuwad, Usha Pandey, K Kamaleshwaran, Ajit Shinto, Ashutosh Dash
INTRODUCTION: The scope of using no carrier added (NCA) (90)Y [T(1/2) = 64.1 h, Eβ(max) = 2.28 MeV] obtained from (90)Sr/(90)Y generator in radiation synovectomy (RSV) is widely accepted. In the present study, the prospect of using (90)Y produced by (n,γ) route in a medium flux research reactor for use in RSV was explored. METHODS: Yttrium-90 was produced by thermal neutron irradiation of Y(2)O(3) target at a neutron flux of ~1×10(14) n/cm(2).s for 14 d. The influence of various experimental parameters were systematically investigated and optimized to arrive at the most favorable conditions for the formulation of (90)Y labeled hydroxyapatite (HA) using HA particles of 1-10 μm size range...
May 2015: Nuclear Medicine and Biology
Koramadai Karuppusamy Kamaleshwaran, Venkataraman Rajamani, Subbiah Gounder Thirumalaisamy, Sudipta Chakraborty, Radhakrishnan Kalarikal, Vyshakh Mohanan, Ajit Sugunan Shinto
Rheumatoid arthritis is a chronic disease that is mainly characterized by asymmetric erosive synovitis, particularly affecting the peripheral joints. Radiation synovectomy or radiosynovectomy, also known as radiosynoviorthesis was first described in 1950's as a adjuvant treatment for rheumatoid arthritis. Radiosynovectomy is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. Lu-177 has presence of gamma photons of imagable energy with low abundance which provides the additional benefit of carrying out simultaneous scintigraphy...
October 2014: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Brent Mollon, Anthony M Griffin, Peter C Ferguson, Jay S Wunder, John Theodoropoulos
PURPOSE: There are few reports detailing recurrence rates or functional outcomes after combined arthroscopic and open synovectomy to treat diffuse pigmented villonodular synovitis (DPVNS) of the knee. METHODS: Patients with DPVNS of the knee treated with combined synovectomy, followed for a minimum of 12 months at a tertiary orthopaedic oncology centre, were identified. We extracted data pertaining to demographics, complications, clinical outcomes and recurrence...
January 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Andras Polyak, Tapas Das, Sudipta Chakraborty, Reka Kiraly, Gabriella Dabasi, Robert Peter Joba, Csaba Jakab, Julianna Thuroczy, Zita Postenyi, Veronika Haasz, Gergely Janoki, Gyozo A Janoki, Maroor R A Pillai, Lajos Balogh
The present article describes the preparation, characterization, and biological evaluation of Thulium-170 ((170)Tm) [T1/2 = 128.4 days; Eβmax = 968 keV; Eγ = 84 keV (3.26%)] labeled tin oxide microparticles for its possible use in radiation synovectomy (RSV) of medium-sized joints. (170)Tm was produced by irradiation of natural thulium oxide target. 170Tm-labeled microparticles were synthesized with high yield and radionuclidic purity (> 99%) along with excellent in vitro stability by following a simple process...
October 2014: Cancer Biotherapy & Radiopharmaceuticals
Jean-Charles Aurégan, Shahnaz Klouche, Yoann Bohu, Nicolas Lefèvre, Serge Herman, Philippe Hardy
PURPOSE: We aimed to determine the rate of local recurrence, the rate of postoperative complications, and the functional outcome at final follow-up of surgical and nonsurgical treatment approaches for pigmented villonodular synovitis (PVNS) of the knee. METHODS: Medline, Embase, and the Cochrane Library were systematically searched for studies that reported the results of treatment for any type of PVNS between January 1, 1950, and August 1, 2013. Two authors extracted the data independently using predefined data fields including study quality indicators...
October 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
Sudipta Chakraborty, K V Vimalnath, A Rajeswari, Ajit Shinto, H D Sarma, K Kamaleshwaran, P Thirumalaisamy, Ashutosh Dash
While radiation synovectomy (RSV) constitutes a successful paradigm for the treatment of arthritis, a major cornerstone of its success resides in the selection of appropriate radiolabeled agent. Among the radionuclide used for RSV, the scope of using (177)Lu [T1/2  = 6.65 d, Eβ(max)  = 497 keV, Eγ  = 113 KeV (6.4%), 208 KeV (11%)] seemed to be attractive owing to its suitable decay characteristics, easy availability, and cost-effective production route. The present article describes a formulation of (177)Lu-labeled hydroxyapatite (HA) using ready-to-use kits of HA particles of 1-10 µm size range...
June 15, 2014: Journal of Labelled Compounds & Radiopharmaceuticals
Emerito Carlos Rodriguez-Merchan
Radiosynovectomy (RS) is the best choice for patients with persistent synovitis of the knee unresponsive to a 3-month trial of prophylactic factor replacement. If three consecutive RSs with 6-month intervals have been ineffective, an arthroscopic synovectomy should be indicated in patients older than 12 years of age (adolescents). In children younger than 12 years of age, adequate prophylaxis should be maintained, with arthroscopic synovectomy always being the last resort. In the knee, we recommend Yttrium-90 at a dose of 90 mBq in children and 185 mBq in adults...
August 2014: Expert Review of Hematology
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