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Radiation synovectomy with (166)Ho-ferric hydroxide: a first experience
Sedat Ofluoglu1, Eva Schwameis, Harald Zehetgruber
1Department of Nuclear Medicine, University of Vienna, Austria.
Summary
Radiation synovectomy using holmium-166 ferric hydroxide (166Ho-FH) macroaggregates is safe and effective for chronic synovitis. This treatment showed a 71% response rate with minimal leakage, offering a promising alternative for patients unresponsive to conventional therapies.
Area of Science:
- Nuclear Medicine
- Radiopharmacology
- Rheumatology
Background:
- Chronic synovitis often requires advanced treatments when pharmacologic options fail.
- Radiation synovectomy (RS) utilizes radioactive particles to manage persistent joint inflammation.
- (166)Holmium-FH macroaggregates present potential for RS but lack extensive clinical data.
Purpose of the Study:
- To evaluate the efficacy and safety of (166)Ho-FH macroaggregates in radiation synovectomy for chronic synovitis.
- To assess clinical outcomes and potential adverse effects of this novel radiopharmaceutical.
Main Methods:
- A prospective clinical trial involving 22 patients with chronic synovitis.
- Administered 24 intraarticular injections of (166)Ho-FH, with a mean activity of 1.11 GBq.
- Monitored for leakage using whole-body gamma-camera imaging and assessed clinical parameters post-injection.
Main Results:
- Seventy-one percent (17/24) of patients experienced a complete or partial response to (166)Ho-FH radiation synovectomy.
- No significant leakage to non-target organs was observed in 18 treatments; minimal leakage (<1%) detected in lymph nodes, lungs, or liver in others.
- Negligible leakage into the bloodstream confirmed the localized action of the treatment.
Conclusions:
- Radiation synovectomy with (166)Ho-FH is a safe and effective treatment for chronic synovitis of various origins.
- Further controlled clinical trials are warranted to compare (166)Ho-FH with other radionuclides and glucocorticosteroids.