Biological dosimetry after radiosynoviorthesis with rhenium-186 sulphide and erbium-169 citrate

Abstract

No significant biological radiation effect can be detected after RSO with 186Re and 169Er, also in cases of high leakage. Therefore, RSO can be classified as a save therapeutic procedure without a relevant radiation risk.

The EANM guideline for radiosynoviorthesis

“…The available data mainly measured activity leakage from RSO of the ankle and the upper extremity joints. The total mean leakage ranged from 2.5 to 3.9% [ 141 , 146 , 147 ]. Whether joint-related differences exist has not yet been investigated.…”

“…The organ doses were calculated to be 100 ± 80 mGy for the liver, 203 ± 229 mGy for the spleen, 94 ± 113 mGy for the kidney, and 26 Gy (range 0–189) to the lymph nodes (when joint immobilization was not possible), respectively [ 141 ]. After RSO of the wrist, no significant increase of dicentric chromosomes could be found [ 146 ].…”

“…The whole-body radiation dose was calculated to be 4.1 ± 2.5 mGy and < 1 mGy/30 MBq, respectively [ 31 , 148 ]. An increase in chromosomal aberrations could not be found [ 146 , 148 ].…”

“…The effective doses for RSO given in dosimetry studies seem to be in the low-dose range when there is no major leakage [ 146 , 181 ]. Radiocolloid particles that leak out of treated joints could accumulate in the regional lymph nodes and the liver.…”

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]. При проведении РСО с применением 90 Y у больных РА не было выявлено повышения риска разви-тия злокачественных новообразований в сравнении с па-циентами, получившими только медикаментозное лече-ние [12].…”