Comparison of Tc-99m HIG and three-phase Tc-99m MDP bone scintigraphy for evaluating the efficacy of Yttrium-90 silicate radionuclide synovectomy.

Abstract

PURPOSE:

The aim of this study was to compare Tc-99m human immunoglobulin (HIG) and three-phase Tc-99m MDP bone scintigraphy for the assessment of the efficacy of Y-90 silicate therapy in rheumatoid knee synovitis.

MATERIALS AND METHODS:

Fifteen patients with rheumatoid arthritis and chronic persistent synovitis in 23 knee joints had radionuclide synovectomy with Y-90 silicate. The patients underwent imaging before and 3, 6, 9, and 12 months after therapy using clinical evaluation, Tc-99m HIG scintigraphy, and three-phase Tc-99m MDP bone scintigraphy.

RESULTS:

In the 13 of 23 knee joints that showed successful clinical results with Y-90 therapy, the Tc-99m HIG index values obtained 3 months after radionuclide synovectomy were significantly lower than the pretreatment index values (P < 0.001). In the same 13 joints, the Tc-99m MDP index values (in the blood-pool and delayed phases) before and 3 months after therapy were statistically similar. Six months after injection, these values were significantly lower in both the blood-pool (P < 0.001) and late (P < 0.05) phases in all 13 joints. In the other 10 of 23 knee joints that did not respond to treatment, the Tc-99m MDP and Tc-99m HIG index values were statistically similar before and after Y-90 therapy.

CONCLUSIONS:

Based on these findings, Tc-99m HIG scintigraphy appears to be a valuable method that complements clinical assessment of the efficacy of Y-90 silicate therapy in rheumatoid knee synovitis, starting in the early post-treatment period. However, three-phase Tc-99m MDP bone scintigraphy may be valuable in the late postsynovectomy period.

• 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. 28 Issue 4 Pg. 277-85 (Apr 2003) ISSN: 0363-9762 [Print] United States
• PMID: 12642704 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Twin Study)

Chemical References

• Immunoglobulins
• Radiopharmaceuticals
• Silicates
• technetium Tc 99m immunoglobulin
• yttrium silicate
• Yttrium
• Technetium
• Technetium Tc 99m Medronate

Topics

• Adult
• Arthritis, Rheumatoid (complications, diagnostic imaging, radiotherapy)
• Female
• Follow-Up Studies
• Humans
• Immunoglobulins
• Knee Joint (diagnostic imaging, radiation effects)
• Male
• Middle Aged
• Radionuclide Imaging
• Radiopharmaceuticals (therapeutic use)
• Reproducibility of Results
• Sensitivity and Specificity
• Silicates (therapeutic use)
• Synovial Membrane (diagnostic imaging, radiation effects)
• Synovitis (diagnostic imaging, etiology, radiotherapy)
• Technetium
• Technetium Tc 99m Medronate
• Treatment Outcome
• Yttrium (therapeutic use)