Outpatient treatment for haemophilic arthropathy with radiosynovectomy: Radiation dose to family members

Abstract

One of the key features of good practice in medicine is the doctor‐patient communication. Radiation protection standards for radiosynovectomy (RS) is limited. Yttrium‐90 is a beta‐emitting radioisotope used in RS to treat joint pain from haemophilic arthritis. ICRP 94 states that if a patient is treated with up to 200 MBq, there is no need for further precautions when it comes to public exposure, however, activities can go up to 370 MBq in RS for the knee. This study analysed 119 family members’ safety (16.7% pregnant women). The ambient dose equivalent rate was measured within four distances. A survey was carried analysing risk groups and time spent next to patients. Results showed that family members should be advised to remain at 1.0 m from the patient to decrease accumulated dose by 97.6%. The dose per activity factors estimated in this study is also a useful tool during the risk assessment and doctor/patient communication. Pamphlets were distributed with radiation protection recommendations. Ambient dose equivalent was low enough to show that RS is a safe procedure for family members, which is essential to promote adherence to RS in countries where it is needed but not performed due to lack of information on radiation safety.

Recurrence-Free Survival after Synovectomy and Subsequent Radiosynoviorthesis in Patients with Synovitis of the Knee—A Retrospective Data Analysis

“…Advising these particular individuals to stay around 1.0 m away from the patient is recommended. The study by Oliveria et al highlights the recorded ambient dose equivalent and shows that RSO is a safe procedure for family members [27].…”

Diagnostic and treatment methods of skeletal symptoms of haemophilia and education of patients regarding the disease – review study

“…It is a procedure consisting of the destruction of the inflamed synovium with radiation. Radioisotopes such as Yttrium-90, Rhenium-186 or Rhenium-188 can be used in this method [11,12]. Radiosynovectomy might be a treatment of choice in treating haemophilic arthropathy as it has been shown to reduce bleeding by 65% [11].…”

“…Radiosynovectomy might be a treatment of choice in treating haemophilic arthropathy as it has been shown to reduce bleeding by 65% [11]. It is important to remain a 1-metre distance from the patient treated with radiation to decrease other people's exposure to radiation [12].…”

Radiosynovectomy for the Treatment of Chronic Hemophilic Synovitis: An Old Technique, but Still Very Effective

“…Table 1 summarizes the most important articles on the subject [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75]. Hemophilic synovitis can be effectively treated with RS.…”

“…In the knee we use Yttrium-90 [185 Megabecquerels (MBq)]. Rhenium-186 is used for elbows (56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74) and ankles (74 MBq). A small quantity of 99Tc (technetium) is introduced to perform articular scintigraphy after the procedure (to confirm the right dispersion of the radioisotope into the joint) [15][16][17][18][19][20].…”