Radiosynovectomy - a method of inflammatory joints diseases treatment with the use of isotopes
Zverev A.V.1, Krylov V.V.2, Khanov A.G.3, Kochetova T.Yu.2
1 «Medradiopreparat» factory - branch of «Federal center for design and development of nuclear medicine facilities» of Federal Medical and Biological Agency of Russia, Moscow
2 Medical Radiological Research Center named after A. Tsyb - branch of «National Medical Research Radiological Center», Obninsk
3 Regional Clinical Hospital No. 2, Rostov-on-Don
Radiosynovectomy is one of the effective methods of treatment of inflammatory joints diseases. The method is based on the intra-articular introduction of radiopharmaceuticals (RFAs) containing beta-emitting isotopes. When the RFA is locally introduced into the joint, it affects the synovium of the joint, which leads to the formation of its superficial fibrosis and the suppression of inflammation. The choice of a particular RFA with the certain radiation power of isotope, which is part of its composition, depends on the size of the tender joint. A large world practice experience in the use of radiopharmaceutical agents has been accumulated since 1923. The presented literature review confirms the effectiveness and safety of this method. A positive response in rheumatoid arthritis can reach 85%. It can be even higher in hemophilic arthropathy. The total radiation load does not pose a risk to healthy organs and tissues. Russian scientists are developing the innovative preparations for radiosynovectomy based on rhenium-188 as one of the most promising medical isotopes.
Key words: radiosynovectomy, radiosynoviorthosis, synovitis, rheumatoid arthritis, rhenium-188.
For citation: Zverev A.V., Krylov V.V., Khanov A.G., Kochetova T.Yu. Radiosynovectomy - a method of inflammatory joints diseases treatment with the use of isotopes // RMJ. MEDICAL REVIEW. 2017. № 1. P. 36–41.
References
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9. Kampen W.U., Brenner W., Kroeger S. et al. Long-term results of radiation synovectomy: a clinical follow-up study // Nucl Med Commun. 2001. Vol. 22(2). P. 239–246.
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18. Kampen W.U., Voth M., Pinkert J., Krause A. Therapeutic status of radiosynoviorthesis of the knee with yttrium [90Y] colloid in rheumatoid arthritis and related indications // Rheumatology (Oxford). 2007. Vol. 46. P. 16–24.
19. Farahati J., Reiners C., Fischer M. et al. Leitlinie für die Radiosynoviorthese // Nuclear-Medizin. 1999. Vol. 38 (6A). P. 254–255.
20. Clunie G., Fischer M., EANM EANM Procedure Guidelines for Radiosynovectomy // Eur J Nucl Med Mol Imaging. 2003. Vol. 30. P. 12–16.
21. Liepe K., Крылов В.В. Радиосиновиортез в лечении воспалительных заболеваний суставов // Научно-практическая ревматология. 2013. № 6. C. 7 [Liepe K., Krylov V.V. Radiosynoviorthez v lechenii vospalitelnih zabolevanii sustavov // Nauchno-prakticheskaya revmatologiya 2013. № 6. S. 7 (in Russian)].
22. Kresnik E., Mikosch P., Gallowitsch H.J. et al. Clinical outcome of radiosynoviorthesis: A meta-analysis including 2190 treated joints // Nucl Med Commun. 2002. Vol. 23. P. 683–688.
23. Deutsch E., Brodack J.W., Deutsch K.F. Radiation synovectomy revisited // Eur J Nucl Med. 1993. Vol. 20 (11). P. 1113–1127.
24. Soroa V.E., del Huerto Velazquez Espeche M., Giannone C. et al. Effects of radiosynovectomy with p-32 colloid therapy in hemophilia and rheumatoid arthritis // Cancer Biother Radiopharm. 2005. T. 20, № 3. C. 344–3448.
25. Li P., Chen G., Zhang H., Shen Z. Radiation synovectomy by 188Re-Sulfide in haemophilic synovitis // Haemophilia. 2004. Vol. 10 (5). P. 422–427.
26. Liepe K., Zaknun J. J., Padhy A. et al. Radiosynovectomy using yttrium-90, phosphorus-32 or rhenium-188 radiocolloids versus corticoid instillation for rheumatoid arthritis of the knee // Ann Nucl Med. 2011. Vol. 25 (5). P. 317–323.
27. Wang S. J., Lin W. Y., Hsieh B. T. et al. Jr. Rhenium-188 sulphur colloid as a radiation synovectomy agent // Eur J Nucl Med. 1995. Vol. 22 (6). P. 505–507.
28. Wang S.J., Lin W.Y., Chen M.N. et al. Intratumoral injection of rhenium-188 microspheres into an animal model of hepatoma // J Nucl Med. 1998. Vol. 39 (10). P. 1752–1757.
29. Wang S.J., Lin W.Y., Chen M.N. et al. Histologic study of effects of radiation synovectomy with Rhenium-188 microsphere // Nucl Med Biol. 2001. Vol. 28 (6). P. 727–732.
30. Lee E. B., Shin K. C., Lee Y. J. et al. 188Re-tin-colloid as a new therapeutic agent for rheumatoid arthritis // Nucl Med Commun. 2003.Vol. 24 (6). P. 689–696.
31. Li P., Yu J., Chen G. et al. Applied radioactivity in radiation synovectomy with (188Re)rhenium sulfide suspension // Nucl Med Commun. 2006.Vol. 27 (8). P. 603–609.
32. Ures M., Savio E., Malanga A. et al. Physico-chemical characterisation and biological evaluation of 188-Rhenium colloids for radiosynovectomy // BMC Nucl Med. 2002. Vol. 2 (1). P. 1.
33. Zaknun J.J., Liepe K., Gaudiano J. et al. Blood and urine biokinetics of rhenium-188-in and phosphorus-32 colloids in radiosynovectomy // Eur J Nucl Med Mol Imaging. Vol. 34. Springer 233 spring street, New York, NY 10013 USA, 2007. P. S359–S359.
34. Liepe K., Faulhaber D., Wunderlich G. et al. Radiation Pneumopathy in the Rat After Intravenous Application of 188 Re-Labeled Microspheres // International Journal of Radiation Oncology Biology Physics. 2011. Vol. 81 (2). P. 529–536.
35. Zaknun J.J., Liepe K., Soroa V. et al. Management of haemarthrosis applying radiosynovectomy in haemophilia patients with emphasis on developing countries // Eur J Nucl Med Mol Imaging. 2007. Vol. 34 P. S352.
36. Kamaleshwaran K.K., Rajamani V., Krishnan B. et al. Radiosynovectomy of Proximal Interphalangeal Joint Synovitis in Rheumatoid Arthritis Treated with Rhenium-188 Labeled Tin-colloid and Imaging with Single-photon Emission Computerized Tomography / Computed Tomography: A First Case Report // World Journal of Nuclear Medicine (Online). 2015. Vol. 14 (3). P. 216–218.
37. Shinto A.S., Kamaleshwaran K.K., Chakraborty S. et al. Radiosynovectomy of Painful Synovitis of Knee Joints Due to Rheumatoid Arthritis by Intra-Articular Administration of 177Lu-Labeled Hydroxyapatite Particulates: First Human Study and Initial Indian Experience // World Journal of Nuclear Medicine (Online). 2015. Vol. 14 (2). P. 81–88.
38. Zalewska J., Wegierska M., Barczynska T. et al. Efficacy of radiation synovectomy (radiosynovectomy or radiosynoviorthesis) with yttrium-90 in exudative inflammation of synovial membrane of knee joints in patients with rheumatic diseases - preliminary report // Reumatologia. 2016. Vol. 54 (1). P. 3–9.
39. Sood A., Sharma A., Chouhan D.K. et al. Failed Radiation Synovectomy in Diseased Knee Joint with Missed Tuberculous Synovitis // World J Nucl Med. 2016. Vol. 15 (3). P. 206–208.
40. Clunie G., Fischer M., Eanm. EANM procedure guidelines for radiosynovectomy // Eur J Nucl Med Mol Imaging. 2003. Vol. 30 (3). P. 12–16.
41. Петриев В.М. Закономерности образования комплексного соединения 188Re с микросферами альбумина крови человека // Радиохимия. 2009. T. 51, № 5. C. 446–451 [Petriev V. M. Zakonomernosti obrazovanija kompleksnogo soedinenija 188Re s mikrosferami al'bumina krovi cheloveka // Radiohimija. 2009. T. 51, № 5. C. 446–451 (in Russian)].
42. Скворцов В.Г., Степаненко В.Ф., Петриев В.М. и др. Фармакокинетические и дозиметрические характеристики нового радиофармпрепарата Re-188-микросферы альбумина // Радиационная биология. Радиоэкология. 2010. T. 50, № 6. C. 703–711 [Skvorcov V. G., Stepanenko V. F., Petriev V. M. i dr. Farmakokineticheskie i dozimetricheskie harakteristiki novogo radiofarmpreparata Re-188-mikrosfery al'bumina // Radiacionnaja biologija Radiojekologija. 2010. T. 50, № 6. C. 703–711 (in Russian)].
2. Ishido C. Über die Wirkung des Radiothoriums auf die Gelenke.Strahlentherapie. Book Über die Wirkung des Radiothoriums auf die Gelenke.Strahlentherapie // Editor. 1923. P. 537–544.
3. Fellinger K., Schmid J. Die lokale Behandlung der rheumatischen Erkrankungen // Wien Z Inn Med. 1952. T. 33. № 9. P. 351–363.
4. Ansell B.M., Crook A., Mallard J.R., Bywaters E.G.L. Evaluation of Intra-articular Colloidal Gold Au 198 in the Treatment of Persistent Knee Effusions // Annals of the Rheumatic Diseases. 1963. Vol 22 (6). P. 435–439.
5. Mödder G. Radiosynoviorthesis (Radiation Synovectomy) // Clinical Nuclear Medicine Biersack H.-J., Freeman L. M. Berlin, Heidelberg: Springer Berlin Heidelberg. 2007. P. 512–518.
6. Дроздовский Б.Я., Иконников А.И., Крылов В.В. Радиосиновиортез в лечении больных ревматоидным артритом // Медицинская радиология. 1990. T. 7. C. 6–9 [Drozdovskij B.Ja., Ikonnikov A.I., Krylov V.V. Radiosinoviortez v lechenii bol'nyh revmatoidnym artritom // Medicinskaja radiologija. 1990. T. 7. C. 6–9 (in Russian).]
7. Mödder G. Radiosynoviorthesis. Involvement of nuclear medicine in rheumatology and orthopaedics // Meckenheim. 1995.
8. Mödder G. Nuklearmedizinische Therapy (RadioSynoviorthese) in Rheumatologie und Orthopaedie. Der Nuklearmediziner. 1995. Vol. 18. P. 15–32.
9. Kampen W.U., Brenner W., Kroeger S. et al. Long-term results of radiation synovectomy: a clinical follow-up study // Nucl Med Commun. 2001. Vol. 22(2). P. 239–246.
10. Kampen W.U., Brenner W., Czech N., Henze E. Intraarticular application of unsealed beta-emitting radionuclides in the treatment course of inflammatory joint disorders. Book Intraarticular application of unsealed beta-emitting radionuclides in the treatment course of inflammatory joint disorders // Editor. 2002. P. 77–87.
11. Kampen W.U., Voth M., Pinkert J., Krause A.Therapeutic status of radiosynoviorthesis of the knee with yttrium [90Y] colloid in rheumatoid arthritis and related indications // Book Therapeutic status of radiosynoviorthesis of the knee with yttrium [90Y] colloid in rheumatoid arthritis and related indications // Editor. 2007. P. 16–24.
12. Fischer M., Mödder G. Radionuclide therapy of inflammatory joint diseases // Nucl Med Commun. 2002. Vol. 23 (9). P. 829–831.
13. Hoefnagel C.A., Clarke S.E.M., Fischer M. et al. Radionuclide therapy practice and facilities in Europe // European Journal of Nuclear Medicine. 1999. Vol. 26 (3). P. 277–282.
14. Farahati J., Schneider P., Reiners C. Radionuklidtherapie bei entzündlichen Gelenkerkrankungen: Schlusswort // Dtsch Arztebl International. 2006. Vol. 103 (41). P. 2719.
15. Brenner W. Grundlagen und Technik der Radiosynoviorthese // Nuklearmediziner. 2006. Vol. 29 (01). P. 5–14.
16. Das B.K., Mödder G., Pradhan P.K., Shukla A.K. Concept of radiosynovectomy. A novel approach in the treatment of joint disorders // Book Concept of radiosynovectomy. A novel approach in the treatment of joint disorders // Editor. 2004. P. 1–5.
17. Mödder G., Mödder-Reese R. Radiosynoviorthesis (radiation synovectomy): State of the Art 2011 // Book Radiosynoviorthesis (radiation synovectomy): State of the Art 2011 // Editor. 2011. P. 154–155.
18. Kampen W.U., Voth M., Pinkert J., Krause A. Therapeutic status of radiosynoviorthesis of the knee with yttrium [90Y] colloid in rheumatoid arthritis and related indications // Rheumatology (Oxford). 2007. Vol. 46. P. 16–24.
19. Farahati J., Reiners C., Fischer M. et al. Leitlinie für die Radiosynoviorthese // Nuclear-Medizin. 1999. Vol. 38 (6A). P. 254–255.
20. Clunie G., Fischer M., EANM EANM Procedure Guidelines for Radiosynovectomy // Eur J Nucl Med Mol Imaging. 2003. Vol. 30. P. 12–16.
21. Liepe K., Крылов В.В. Радиосиновиортез в лечении воспалительных заболеваний суставов // Научно-практическая ревматология. 2013. № 6. C. 7 [Liepe K., Krylov V.V. Radiosynoviorthez v lechenii vospalitelnih zabolevanii sustavov // Nauchno-prakticheskaya revmatologiya 2013. № 6. S. 7 (in Russian)].
22. Kresnik E., Mikosch P., Gallowitsch H.J. et al. Clinical outcome of radiosynoviorthesis: A meta-analysis including 2190 treated joints // Nucl Med Commun. 2002. Vol. 23. P. 683–688.
23. Deutsch E., Brodack J.W., Deutsch K.F. Radiation synovectomy revisited // Eur J Nucl Med. 1993. Vol. 20 (11). P. 1113–1127.
24. Soroa V.E., del Huerto Velazquez Espeche M., Giannone C. et al. Effects of radiosynovectomy with p-32 colloid therapy in hemophilia and rheumatoid arthritis // Cancer Biother Radiopharm. 2005. T. 20, № 3. C. 344–3448.
25. Li P., Chen G., Zhang H., Shen Z. Radiation synovectomy by 188Re-Sulfide in haemophilic synovitis // Haemophilia. 2004. Vol. 10 (5). P. 422–427.
26. Liepe K., Zaknun J. J., Padhy A. et al. Radiosynovectomy using yttrium-90, phosphorus-32 or rhenium-188 radiocolloids versus corticoid instillation for rheumatoid arthritis of the knee // Ann Nucl Med. 2011. Vol. 25 (5). P. 317–323.
27. Wang S. J., Lin W. Y., Hsieh B. T. et al. Jr. Rhenium-188 sulphur colloid as a radiation synovectomy agent // Eur J Nucl Med. 1995. Vol. 22 (6). P. 505–507.
28. Wang S.J., Lin W.Y., Chen M.N. et al. Intratumoral injection of rhenium-188 microspheres into an animal model of hepatoma // J Nucl Med. 1998. Vol. 39 (10). P. 1752–1757.
29. Wang S.J., Lin W.Y., Chen M.N. et al. Histologic study of effects of radiation synovectomy with Rhenium-188 microsphere // Nucl Med Biol. 2001. Vol. 28 (6). P. 727–732.
30. Lee E. B., Shin K. C., Lee Y. J. et al. 188Re-tin-colloid as a new therapeutic agent for rheumatoid arthritis // Nucl Med Commun. 2003.Vol. 24 (6). P. 689–696.
31. Li P., Yu J., Chen G. et al. Applied radioactivity in radiation synovectomy with (188Re)rhenium sulfide suspension // Nucl Med Commun. 2006.Vol. 27 (8). P. 603–609.
32. Ures M., Savio E., Malanga A. et al. Physico-chemical characterisation and biological evaluation of 188-Rhenium colloids for radiosynovectomy // BMC Nucl Med. 2002. Vol. 2 (1). P. 1.
33. Zaknun J.J., Liepe K., Gaudiano J. et al. Blood and urine biokinetics of rhenium-188-in and phosphorus-32 colloids in radiosynovectomy // Eur J Nucl Med Mol Imaging. Vol. 34. Springer 233 spring street, New York, NY 10013 USA, 2007. P. S359–S359.
34. Liepe K., Faulhaber D., Wunderlich G. et al. Radiation Pneumopathy in the Rat After Intravenous Application of 188 Re-Labeled Microspheres // International Journal of Radiation Oncology Biology Physics. 2011. Vol. 81 (2). P. 529–536.
35. Zaknun J.J., Liepe K., Soroa V. et al. Management of haemarthrosis applying radiosynovectomy in haemophilia patients with emphasis on developing countries // Eur J Nucl Med Mol Imaging. 2007. Vol. 34 P. S352.
36. Kamaleshwaran K.K., Rajamani V., Krishnan B. et al. Radiosynovectomy of Proximal Interphalangeal Joint Synovitis in Rheumatoid Arthritis Treated with Rhenium-188 Labeled Tin-colloid and Imaging with Single-photon Emission Computerized Tomography / Computed Tomography: A First Case Report // World Journal of Nuclear Medicine (Online). 2015. Vol. 14 (3). P. 216–218.
37. Shinto A.S., Kamaleshwaran K.K., Chakraborty S. et al. Radiosynovectomy of Painful Synovitis of Knee Joints Due to Rheumatoid Arthritis by Intra-Articular Administration of 177Lu-Labeled Hydroxyapatite Particulates: First Human Study and Initial Indian Experience // World Journal of Nuclear Medicine (Online). 2015. Vol. 14 (2). P. 81–88.
38. Zalewska J., Wegierska M., Barczynska T. et al. Efficacy of radiation synovectomy (radiosynovectomy or radiosynoviorthesis) with yttrium-90 in exudative inflammation of synovial membrane of knee joints in patients with rheumatic diseases - preliminary report // Reumatologia. 2016. Vol. 54 (1). P. 3–9.
39. Sood A., Sharma A., Chouhan D.K. et al. Failed Radiation Synovectomy in Diseased Knee Joint with Missed Tuberculous Synovitis // World J Nucl Med. 2016. Vol. 15 (3). P. 206–208.
40. Clunie G., Fischer M., Eanm. EANM procedure guidelines for radiosynovectomy // Eur J Nucl Med Mol Imaging. 2003. Vol. 30 (3). P. 12–16.
41. Петриев В.М. Закономерности образования комплексного соединения 188Re с микросферами альбумина крови человека // Радиохимия. 2009. T. 51, № 5. C. 446–451 [Petriev V. M. Zakonomernosti obrazovanija kompleksnogo soedinenija 188Re s mikrosferami al'bumina krovi cheloveka // Radiohimija. 2009. T. 51, № 5. C. 446–451 (in Russian)].
42. Скворцов В.Г., Степаненко В.Ф., Петриев В.М. и др. Фармакокинетические и дозиметрические характеристики нового радиофармпрепарата Re-188-микросферы альбумина // Радиационная биология. Радиоэкология. 2010. T. 50, № 6. C. 703–711 [Skvorcov V. G., Stepanenko V. F., Petriev V. M. i dr. Farmakokineticheskie i dozimetricheskie harakteristiki novogo radiofarmpreparata Re-188-mikrosfery al'bumina // Radiacionnaja biologija Radiojekologija. 2010. T. 50, № 6. C. 703–711 (in Russian)].
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