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Knee radiosynovectomy with 153Sm-hydroxyapatite compared to 90Y-hydroxyapatite: initial results of a prospective trial

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Abstract

Introduction

Radiosynovectomy (RS) with 90Y-hydroxyapatite (90Y-HyA) aims to control knee hemarthrosis in hemophiliac patients to prevent secondary arthropathy. However, knee RS using 153Sm-hydroxyapatite (153Sm-HyA) is considered less suitable due to the lower average soft tissue range and energy of 153Sm for large joints, such as the knees.

Purpose

The objective of this investigation was to assess the efficacy and safety of knee RS with 153Sm-HyA, compared to 90Y-HyA.

Methods

Forty patients were prospectively assigned to undergo knee RS with 153Sm-HyA (n = 19) or with 90Y-HyA (n = 21). The frequency of hemarthrosis episodes before and after treatment were compared.

Results

After six months of knee RS, 153Sm-HyA and 90Y-HyA promoted a similar reduction of hemarthrosis episodes (50% and 66.7%, respectively). However, after 12 months of knee RS, the reduction of hemarthrosis episodes was significantly (p = 0.037) higher using 153Sm-HyA (87.5%) compared to 90Y-HyA (50.0%). This discrepancy was more pronounced (p = 0.002) for 153Sm-HyA compared to 90Y-HyA in adults/adolescents.

Conclusion

Knee radiosynovectomy with 153Sm-HyA is safe, reduces hemarthrosis episodes after 12 months of treatments, especially in adults/adolescents and even with grades III/IV arthropathy, similar to 90Y-HyA. 90Y-HyA seems to promote better hemarthrosis control in small children.

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Acknowledgements

We thank the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP # 2013/05255-7) for partial financing of this investigation. We also thank Efrain Perini (PhD) and Jair Mengatti (PhD) from the Radiopharmacy Center of the Nuclear and Energy Research Institute (IPEN/CNEN), São Paulo, Brazil.

Funding

None.

Author information

Authors and Affiliations

  1. Division of Nuclear Medicine of the Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil

    Allan O. Santos, Luis Fernando M. Pereira, Edna M. Brunetto & Elba C. S. C. Etchebehere

  2. Hemophilia Unit of Hemocentro UNICAMP, University of Campinas (UNICAMP), Campinas, Brazil

    Janaina B. S. Ricciardi, Roberto Zulli & Margareth C. Ozelo

  3. Department of Orthopedics and Traumatology of the Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil

    Rodrigo Pagnano

  4. Division of Ultrasound of the Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil

    Emerson T. Sakuma

  5. Radiopharmacy Center of the Nuclear and Energy Research Institute (IPEN/CNEN), São Paulo, Brazil

    Margareth M. N. Matsuda, Emerson S. Bernardes & Elaine B. Araújo

  6. Center of Biomedical Engineering, University of Campinas, Campinas, Brazil

    Sérgio Q. Brunetto

  7. Gleb Wataghin Physics Institute, University of Campinas, Campinas, Brazil

    Maria Emília S. Takahashi

Authors
  1. Allan O. Santos
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  2. Janaina B. S. Ricciardi
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  3. Rodrigo Pagnano
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  14. Elba C. S. C. Etchebehere
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by AOS, JBSR, RP, MMNM, ESB, ETS, EBA, SQB, EMB, MEST and RZ. The first draft of the manuscript was written by AOS and LFMP. The final draft by AOS, MCO and ECSCE. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Allan O. Santos.

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Santos, A.O., Ricciardi, J.B.S., Pagnano, R. et al. Knee radiosynovectomy with 153Sm-hydroxyapatite compared to 90Y-hydroxyapatite: initial results of a prospective trial. Ann Nucl Med 35, 232–240 (2021). https://doi.org/10.1007/s12149-020-01557-5

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  • DOI: https://doi.org/10.1007/s12149-020-01557-5

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