Yttrium-90 radiation synovectomy in knee osteoarthritis: a prospective assessment at 6 and 12 months.

Objective: To assess the outcome of yttrium-90 radiation synovectomy at 6 and 12 months in patients with knee osteoarthritis unresponsive to systematic or local medical treatment.

Methods: Consecutive patients with osteoarthritic knee pain resistant to conventional therapy and submitted to intraarticular yttrium-90 treatment because of synovial inflammation, as demonstrated by early-phase bone scintigraphy, were prospectively evaluated at 6 and/or 12 months. The assessment of the outcome of treatment was based on self-reporting of relief of knee pain limiting daily activities, measured as percentage reduction of the pretherapeutic joint discomfort with a Visual Analogue Scale.

Yttrium-90 silicate radiosynovectomy treatment of painful synovitis in knee osteoarthritis. Results after 6 months.

Our aim was to evaluate the response of radiation synovectomy (RS) with yttrium-90 silicate ((90)Y-S) treatment of synovitis in patients with knee osteoarthritis (OA) and to derive factors that influence this response. The RS treatment response was assessed prospectively in 74 painful OA knees of 74 patients during a period of 6 months follow up. The duration of the disease was 24 +/- 9 months.

Baker's cysts in knees with chronic osteoarthritic pain: a clinical, ultrasonographic, radiographic and scintigraphic evaluation.

This study aimed to determine the ultrasonographic prevalence of Baker's cysts in knees with chronic osteoarthritic pain and investigate for cysts correlates and relationships with scintigraphically established synovitis. Consecutive patients with chronic osteoarthritic knee pain underwent clinical examination, X-rays, ultrasonography and early-phase bone scintigraphy. Eighty-nine Baker's cysts were detected in 328 knees with chronic osteoarthritic pain (27%), whereas one cyst was identified among the 54 non-osteoarthritic knees (2%, P<0.

[Fetus radiation doses from nuclear medicine and radiology diagnostic procedures. Potential risks and radiation protection instructions].

Although in pregnancy it is strongly recommended to avoid diagnostic nuclear medicine and radiology procedures, in cases of clinical necessity or when pregnancy is not known to the physician, these diagnostic procedures are to be applied. In such cases, counseling based on accurate information and comprehensive discussion about the risks of radiation exposure to the fetus should follow. In this article, estimations of the absorbed radiation doses due to nuclear medicine and radiology diagnostic procedures during the pregnancy and their possible risk effects to the fetus are examined and then discussed.

[Can hand radiation absorbed dose from radiosynomicronvectomy be high?].

Preparing and injecting radiopharmaceuticals containing beta emitting radionuclides, for radiosynovectomy (RS), implies the risk of exceeding the upper limit of skin and hand radiation absorbed dose, of 500 mSv/year to both technologists, who prepare and to doctors, who inject these radiopharmacuticals. A high number of RS treatments per day lack of effective radiation protection devices and skin contamination, increase the skin radiation absorbed dose. Pronounced dosimetric and radiation protection data for radionuclides used for RS, like yttrium-90, erbium-169, rhenium-186, dysprosium-165 and holmium-166, indicate the risk and the rationale for minimizing skin radiation doses to the hands of technologists and to doctors.

Whole-body (131)I washout in a patient with metastatic well-differentiated papillary thyroid carcinoma treated with repeated (131)I administration.

We describe the case of a 37-year-old male patient suffering from papillary carcinoma of the thyroid gland with pulmonary metastases who after total thyroidectomy on 29/07/1998 was submitted to three treatments with high doses of (131)I and studied as to the whole body clearance of (131)I by measuring the dose rate of (131)I. The patient was referred to us for total ablation of post surgery remnant of thyroid tissue on 19/09/1998. Due to lymphadenic metastases and high Tg values: 450 ng/ml, he was purposely given therapeutically a high dose of 5146 MBq (131)I.

[Scintigraphic imaging of knee synovitis in osteoarthritis after intra-articular injection of technetium-99m pertechnetate in the unilateral knee].

A case of left knee synovitis scintigraphic imaging is presented in a 66-year-old patient with bilateral knee osteoarthritis and a right knee Baker's cyst, who had undergone a 74 MBq (99m)Tc-pertechnetate intra-articular injection in the right knee. The findings in this case were compared with the intravenously injected methylene disphosphonate technetium-99m ((99m)Tc-MDP) scintigraphic findings and could be interpreted as the result of (99m)Tc-pertechenate through blood communication from the right to the left knee. This case implies that (99m)Tc-pertechnetate may be useful in imaging the synovitis in multiple arthroses even up to 60 min after its administration, instead of the 5 min imaging after the injection of (99m)Tc-MDP.

[Radiation doses from patients undergoing yttrium-90 silicate knee radiosynovectomy].

The present study was undertaken because we could not find references related to the minimal radiation doses emitted from patients treated with (90)Y-silicate colloid ((90)Y-SC) for radiosynectomy (RS). Radiation doses from 16 patients treated with about 181+/-13 MBq (90)Y-SC for RS of knee synovitis were estimated by dose rate measurements performed within 10 min after the (90)Y-SC injection with a calibrated survey dose ratemeter at 0.5 m, 1 m and 2 m distances from the treated joint.

[The role of 99mTc-ciprofloxacin scan in infection imaging].

In this article there is an attempt, to critically review the literature referring to the clinical validity and clinical applications of in vivo imaging of infected areas of our body, with 99mTc-ciprofloxacin (infection). Infection is the product of labeling a broad spectrum antibiotic, ciprofloxacin, with 99mTc. There is increased interest and expectation that this agent will become a useful tool for every day clinical practice, in discriminating, infectious from inflammatory lesions.

[Costing nuclear medicine diagnostic procedures].

To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities.

[Current trends in infection imaging].

Infection imaging is a field of intense interest in medicine because, despite the great advances in our understanding of microorganisms and the development of new antimicrobial agents, infection remains a major cause of patient morbidity and mortality. Nuclear Medicine for many years has an important role in this field. The significance of this role varies in different clinical situations, in some cases being complementary to other imaging modalities as in postoperative patients, and in some cases being the method of choice as in orthopaedic infections after implants have been placed.

Isolation period prediction in patients with differentiated thyroid carcinoma treated after thyroidectomy by radioiodine-131.

In patients with differentiated thyroid carcinoma (DTC) who after thyroidectomy underwent radioiodine-131 ((131)I) treatment for the ablation of the thyroid remnant, isolation period is considered as the period of time needed for patients' radiation dose rates to be reduced below specific adopted dose rate release limits. The aim of our study was to determine mathematical equations for the prediction of the isolation period in these patients and of their discharge from special isolation rooms in nuclear medicine departments. In order, to predict the duration of the isolation period, we studied twenty-eight patients with DTC and total thyroidectomy having no metastases, who underwent (131)I ablation treatment for a minimal residual thyroid remnant.