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European Journal of Nuclear Medicine

, Volume 24, Issue 4, pp 398–402 | Cite as

Monitoring of the biodistribution and biokinetics of dysprosium-165 ferric hydroxide with a shadow-shield whole-body counter

  • C. Pirich
  • U. Prüfert
  • E. Havlik
  • E. Schwarmeis
  • J Flores
  • H. Kvaternik
  • P. Angelberger
  • J. Aiginger
  • A. Wanivenhaus
  • H. Sinzinger
Original Article
  • 48 Downloads

Abstract

Radiation synovectomy is indicated when conventional pharmacological treatment of chronic synovitis has proved insufficient. In these cases dysprosium-165 ferric hydroxide (DFH) has been demonstrated to be clinically effective. After application of the agent, blood activity measurements and monitoring of activity distribution by gamma camera imaging over the local lymph nodes and the liver are commonly performed for control of possible leakage. In addition, we have used a shadow-shield whole-body counter with a profile facility to evaluate the biokinetics and biodistribution of165Dy-DFH. Fifteen intra-articular injections were performed in 13 patients who received a median activity of 6.8 GBq (range 0.5-9.9 GBq)165Dy-DFH. Activity profiles were obtained with the whole-body counter 2, 4 and 6 h after injection of165Dy-DFH. The doses to non-target organs were calculated using the software MIRDOSE 3. In 10 of 15 treatments, absence of any leakage could be demonstrated. The effect of scattered rays could be observed in 14 measurements. In three patients small amounts of activity could be detected in the urinary bladder and in three patients activity was detected in the local inguinal lymph nodes, while no leakage could be detected by camera imaging. In these cases the individual doses to the bladder were 15 Gy, 65 mGy and 50 mGy, and those to the lymph nodes, 0.54 Gy, 0.89 Gy and 2.41 Gy. The whole-body counter also enabled the monitoring of activity profiles related to more complex pathological structures. In conclusion, using a whole-body counter activity leakage could be detected with much higher sensitivity than by using a gamma camera. The biodistribution of165Dy-DFH could be determined, and leakage could be localised and related to organs. These results encourage the use of a whole-body counter to identify, the site and extent of activity leakage.

Key words

Radiation synovectomy Dysprosium-165 ferric hydroxide Whole-body counter Leakage Dosimetry 

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Reference

  1. 1.
    Ansell BM, Crook A, Mallard JR, Bywaters EGL. Evaluation of intra-articular colloidal Au-198 in the treatment of persistent knee effusions.Ann Rheum Dis 1963; 22: 435–439.PubMedGoogle Scholar
  2. 2.
    Delbarre F, Menkes C, Aignan M, Ingrand J, Lego A, Roucayrol RC. La synoviorthese par les radioisotopes a la main et au poignet.Rev Rhum Mal Osteoartic 1973; 40: 205–209.Google Scholar
  3. 3.
    Gumpel JM, Beer TC, Crawley JCW, Farran HEA. Yttrium-90 in persistent synovitis of the knee - a single centre comparison. The retention and extraarticular spread of four90Y radiocolloids.Br J Radiol 1975; 48: 377–381.PubMedGoogle Scholar
  4. 4.
    Delbarre F, Cayla J, Roucaryol JC, Menkes C, Aignan M, Ingrand J. La synoviorthese par les radioisotopes.Presse Med 1968; 76: 1045–1049.PubMedGoogle Scholar
  5. 5.
    Gumpel JM, Roles NC. A controlled trial of intraarticular radiocolloids versus surgical synovectomy in persistent synovitis.Lancet 1975; 1: 488–489.PubMedGoogle Scholar
  6. 6.
    Oka M, Rekonen A, Routsi A, Seppala O. Intra-articular injection of Y-90 resin colloid in the treatment of rheumatoid knee joint effusions.Acta Rheumatol Scand 1971; 17: 148–160.PubMedGoogle Scholar
  7. 7.
    Deckart H, Tamaschke J, Ett S, Tautz M, Knapp G. Radiosynovectomy of the knee joint with gold-198 colloid, yttrium-90 ferric hydrate colloid and rhenium-168 sulphide colloid.Radiobiol Radiother 1979; 3: 363–370.Google Scholar
  8. 8.
    Hnatowich DJ, Kramer RI, Sledge CB, Noble J, Shortkoff S. Dysprosium-165 ferric hydroxide macroaggregates for radiation synovectomy.J Nucl Med 1977; 19: 303–308.Google Scholar
  9. 9.
    Sledge CB, Zuckerman JD, Zalutsky MR, Atcher RW, Shortkroff S, Lionberger DR, Rose HA, Hurson BJ, Lankenner PA, Anderson RJ, Bloomer WA. Treatment of rheumatoid synovitis of the knee with intra-articular injection of dysprosium 165-ferric hydroxide macroaggregates.Arthritis Rheum 1986; 29: 153–159.PubMedGoogle Scholar
  10. 10.
    Sledge CB, Zuckerman JD, Shortkroff S, Zalutsky MR, Venakatesan P, Snyder MA, Barrett WP. Synovectomy of the rheumatoid knee using intra-articular injection of dysprosium 165-ferric hydroxide macroaggregates.J Bone Joint Surgery Am 1987; 69: 970–975.Google Scholar
  11. 11.
    Edmonds J, Smart R, Laurent R, Butler P, Brooks P, Hosch R, Wiseman J, George S, Lovegrove F, Warwick A, Owen E, Werb J, Booth R, Clemens L, McLaren A, Druce M, Hetherington E, Prosser S, Whitwell J, Lambrecht R. A comparative study of the safety and efficacy of dysprosium-165 hydroxide macro-aggregate and yttrium-90 silicate colloid in radiation synovectomy — a multicenter double blind trial.Br J Rheumatol 1994; 333: 947–953.Google Scholar
  12. 12.
    Pirich C, Wanivenhaus A, Graninger W, Kvaternik H, Pesau B, Angelberger P, Flores J, Sinzinger H. Radiation synovectomy with dysprosium 165-ferric hydroxide macroaggregates.Acta Med Austr 1993; 20: 49–53.Google Scholar
  13. 13.
    Steinbrocher O, Traeger CH, Battermann RC. Therapeutic criteria in rheumatoid arthritis.JAMA 1949; 140: 659.Google Scholar
  14. 14.
    Hübner W, Jaeger RG, eds: Dosimetrie and Strahlenschutz. Stuttgart: Thieme, 1974.Google Scholar
  15. 15.
    Williams ED, Caughey DE, Hurley PJ, John MB. Distribution of yttrium-90-ferric hydroxide colloid and gold-198 colloid after injection into the knee.Ann Rheum Dis 1976; 516–520.Google Scholar
  16. 16.
    Zalutsky MR, Venkatesean PP, English RJ, Shortkoff S, Sledge CB, Aderstein SJ. Radio synovectomy with Dy165-FHMA: Lymph node uptake and radiation dosimetry calculation.Int J Nucl Biol 1986; 12: 457–465.Google Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • C. Pirich
    • 1
  • U. Prüfert
    • 2
  • E. Havlik
    • 3
  • E. Schwarmeis
    • 4
  • J Flores
    • 1
  • H. Kvaternik
    • 5
  • P. Angelberger
    • 5
  • J. Aiginger
    • 2
  • A. Wanivenhaus
    • 4
  • H. Sinzinger
    • 1
  1. 1.Department of Nuclear Medicine, AKHUniversity of ViennaViennaAustria
  2. 2.Atomic Institute of the Austrian UniversitiesViennaAustria
  3. 3.Department of Biomedical Engineering and Physics, AKHUniversity of Vienna and Ludwig Boltzmann Institute of Nuclear MedicineViennaAustria
  4. 4.Department of Orthopedics, AKHUniversity of ViennaAustria
  5. 5.Research Center SeibersdorfAustria

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