The intra-articular distribution of 90yttrium does not influence the clinical outcome of radiation synovectomy of the knee. Issue 8 (12th January 2007)

• Record Type: Journal Article
• Authors: Jahangier, Z N; van der Zant, F M; Jacobs, J W G; Riedstra, H G; Gommans, G M M; Verzijlbergen, J F; Bijlsma, J W J; van Isselt, J W
• Is Part Of: Annals of the rheumatic diseases. Volume 66:Issue 8(2007)
• Page Start: 1110
• Page End: 1112
• Publication Date: 2007-01-12
• Subjects: arthritis -- yttrium -- glucocorticoid -- distribution -- leakage -- CCI, composite change index -- GC, glucocorticoids -- RSO, radiosynoviorthesis -- SF, synovial fluid -- 90Y, 90yttrium-citrate; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2005.047373
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: To assess the impact of the intra-articular distribution of 90 yttrium-citrate ( 90 Y) on the clinical effect of radiosynoviorthesis (RSO) of the knee and on 90 Y leakage from this joint. Methods: Patients with arthritis of the knee received 185 MBq 90 Y combined with a glucocorticoid, followed by clinical bed rest. Intra-articular 90 Y distribution, measured with a dual-head gamma camera immediately or after 24 hours, was scored as mainly diffuse or mainly focal. Leakage to regional lymph nodes, the liver and spleen was assessed with a dual-head gamma camera after 24 hours. Clinical effect was scored after 6 months by a composite change index (CCI), range 0–12; responders were defined as having a CCI ⩾6. Results: Seventy-eight knees of 69 patients, mostly suffering from undifferentiated arthritis (42%) or RA (28%), were treated. 90 Y distribution was mainly diffuse in 54% and mainly focal in 46% with clinical response rates of 40% versus 56%, respectively, p = 0.3. CCI was not correlated with distribution. 90 Y leakage was found only to the liver and the spleen (mean leakage 0.4% and 1.1%, respectively). Leakage was significantly less in case of diffuse intra-articular 90 Y distribution, whereas leakage to the liver was correlated with distribution (r = 0.68, p<0.001). 90 Y leakage was not correlated with CCI. Conclusions: Intra-articular 90 Y distribution does not influence the clinical effect of RSO of the knee. Although 90 Y leakage from the joint is less if 90 Y distributes diffusely in the joint cavity, leakage does not seem to hamper the clinical effect.