Boron Neutron Capture Synovectomy

  • Jacquelyn C. Yanch


Use of the boron neutron capture reaction is a potential means of treating the symptoms of rheumatoid arthritis and related diseases. For this approach, termed boron neutron capture synovectomy (BNCS), the goal is cellular ablation within the inflamed synovium, the membrane lining the inner surface of the joint capsule of all articulating joints. To be effective in destroying the synovial membrane, radiation doses must be very large (approximately 100 Gy in a single delivery), substantially higher than those used in BNCT of tumors where cessation of reproductive capability in malignant cells is the clinical goal. Generating large radiation doses requires that very high boron concentrations be present in the target tissue at the time of irradiation. While it is unlikely that systemic administration of the boron compound can result in the needed synovial boron concentrations, extremely high boron levels can be readily achieved via local delivery, that is, by injection of the compound directly into the joint fluid. This delivery approach results in very high synovial boron levels in vivo, which means that radiation treatment times can be very short. Neutron beams based on accelerator, reactor, and isotope sources have been designed at many institutions around the world, and in some cases, these beams have been built and experimentally characterized. With existing neutron sources, human joint irradiations could be performed in a matter of minutes. The efficacy of BNCS in causing synovial necrosis has been clearly demonstrated in an animal model of arthritis. However, the boron compound used for this study was found to freely enter the articular cartilage leading to unequivocal histological evidence of cartilage damage following neutron irradiation of the joint. The continued development of BNCS as a viable clinical modality thus awaits the identification and testing of an alternative boron-labeled compound, one that will be excluded, perhaps on the basis of physical size, from the cartilage.


Synovial Membrane Neutron Beam Neutron Capture Capture Cross Section Boron Compound 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Departments of Nuclear Science and Engineering and Biological EngineeringMassachusetts Institute of TechnologyCambridgeUSA

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