Abstract | PURPOSE: MATERIALS AND METHODS: Fifteen patients (13 women, 2 men; mean age, 53.5 +/- 8.4 years) with rheumatoid arthritis had radionuclide synovectomy using 185 MBq (5 mCi) Y-90 silicate to evaluate 24 knee joints with chronic persistent synovitis. Radiologic and clinical evaluations and Tc-99m HIG scans were performed in each patient before radionuclide synovectomy. Each patient was reassessed 3, 6, 9, and 12 months after therapy using clinical examination and Tc-99m HIG scintigraphy. RESULTS: In 14 of 24 knee joints (4 Larsen stage I, 10 Larsen stage II) that had excellent or good clinical responses to Y-90 silicate therapy, the Tc-99m HIG index values 3 months after treatment were significantly lower than the pretreatment index values (P < 0.001). In 13 of these 14 joints, these low index values and clinical results remained constant throughout the 1 year of follow-up. One patient (1 of the 14 knee joints) experienced severe pain and swelling as a result of recurrent arthritis at 9 months, and the Tc-99m HIG index value increased at 9 months and remained high 12 months after therapy. In 10 of 24 knee joints (4 Larsen stage II, 6 Larsen stage III) that had a fair or poor clinical response, Tc-99m HIG index values were statistically similar before and after radionuclide therapy. CONCLUSIONS: Quantitative Tc-99m HIG scintigraphy is a valuable method for assessing the efficacy of Y-90 silicate therapy in rheumatoid knee synovitis.
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Authors | Esra Arzu Gencoglu, Gulseren Aras, Ozlem Kucuk, Gulay Atay, Ibrahim Tutak, Sebnem Ataman, Ayfer Soylu, Erkan Ibis |
Journal | Clinical nuclear medicine
(Clin Nucl Med)
Vol. 27
Issue 6
Pg. 395-400
(Jun 2002)
ISSN: 0363-9762 [Print] United States |
PMID | 12045428
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Immunoglobulins
- Silicates
- Yttrium Radioisotopes
- technetium Tc 99m immunoglobulin
- Technetium
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Topics |
- Adult
- Aged
- Arthritis, Rheumatoid
(complications, diagnostic imaging, radiotherapy)
- Chronic Disease
- Female
- Follow-Up Studies
- Humans
- Immunoglobulins
(metabolism)
- Knee Joint
(diagnostic imaging, physiopathology)
- Male
- Middle Aged
- Radionuclide Imaging
- Recurrence
- Severity of Illness Index
- Silicates
(therapeutic use)
- Synovitis
(complications, diagnostic imaging, radiotherapy)
- Technetium
(pharmacokinetics)
- Treatment Outcome
- Yttrium Radioisotopes
(administration & dosage, therapeutic use)
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