Aktivitätsabtransport und Strahlenexposition durch die Radiosynoviorthese des Kniegelenkes: Einfluß unterschiedlicher Therapiemodalitäten

Abstract

In rheumatic diseases, radiation synovectomy is a reliable method. Meanwhile, radiation synovectomy is an outpatient therapy. In addition, combination with arthroscopic synovectomy is an increasing therapeutic modality. In comparison to the hitherto inpatient modality, a greater lymphatic emigration of the radionuclide and, therefore, a higher radiation exposure is possible. In 35 patients we found radionuclide emigration in 17 cases by whole body scintigraphy, resulting in a 50%-percentile with 68.27%-confidence interval of 1.8 (0.45-4.78)% of the injected yttrium-90-activity. Comparison of 3 groups with the above mentioned therapy modalities resulted in no statistical difference (p>0.05). Because of the found radionuclide emigration, a radiation dose of 0. 1 (0.05-0,18) mSv in women and 0.2 (0.1-0.38) mSv in men was calculated. For lymph nodes, liver, spleen and whole body radiation doses of 619 (154-1644) mSv, 62 (15-165) mSv, 62 (15-165) mSv and 37 (9-99) mSv were calculated. Gonadal radiation dose can be neglected and the morbidity rate for tumors because of the whole body radiation dose is low with a value of 0.4 per thousand. Therefore, radiation synovectomy can be used unlimited by patients age and independent of the therapeutic modality.

Radiosynovectomy in the Therapeutic Management of Arthritis

“…In cases of 48 h immobilization after therapy, the leakage rate of radio-colloids is >2%. [ 18 ] In a large Canadian study included >2400 patients with radiosynovectomy using 90 Y, similar risk of cancer in radiosynovectomy patients compared to the cohort to Canadian population were observed. [ 15 ]…”

Radiosynoviorthesis in Therapy for Inflammatory Joint Disorders

“…После 48-часовой иммоби-лизации сустава утечка радиоактивных веществ составля-ет в среднем 2% [10]. Анализ крови после проведения РСО не выявил наличия статистически значимого повы-шения хромосомных аберраций в лимфоцитах, являю-щихся признаком значительной лучевой нагрузки на сис-тему крови [11].…”

“…В результате данного исследования не было выявлено повышения риска развития рака по срав-нению с общей популяцией [13]. Лучевая нагрузка на половые железы тоже незначительна: 0,1 мЗв на яички и 0,2 мЗв на яичники [10].…”

Radionuclide Therapy of Inflammatory Joint Diseases (Radiation Synovectomy, Radiosynoviorthesis)

“…Gonadal radiation dose could be neglected and also the morbidity rate for tumors because of a low body radiation dose (0.4 per 1,000). Conclusion: RSO can be used unlimited by patient age and independent of the therapeutic modality (Klett et al 1999;Klett 2006).…”