Abstract
Beta-particle dosimetry of various radionuclides used in the treatment of rheumatoid arthritis was estimated using Monte Carlo radiation transport simulation coupled with experiments using reactor-produced radionuclides and radiachromic film dosimeters inserted into joint phantoms and the knees of cadavers. Results are presented as absorbed dose factors (cGy-cm2/MBq-s) versus depth in a mathematical model of the rheumatoid joint which includes regions of bone, articular cartilage, joint capsule, and tissue (synovium) found in all synovial joints. The factors can be used to estimate absorbed dose and dose rate distributions in treated joints. In particular, guidance is provided for those interested in (a) a given radionuclide's therapeutic range, (b) the amount of radioactivity to administer on a case-by-case basis, (c) the expected therapeutic dose to synovium, and (d) the radiation dose imparted to other, nontarget components in the joint, including bone and articular cartilage.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Fellinger K, Schmid J. Die lokale Behandlung der rheumatischen Erkrankungen.Wien Z Inn Med 1952; 33: 351.
Deutsch E, Brodack JW, Deutsch KF. Radiation synovectomy revisited.Eur J Nucl Med 1993; 20: 1113–1127.
Harbert JC.Nuclear medicine therapy. New York: Thieme Medical, 1987.
Webb FWS, Lowe J, Bluestone R. Uptake of colloidal radioactive yttrium by synovial membrane.Ann Rheum Dis 1969; 28: 300–302.
Ingrand J. Characteristics of radio-isotopes for intra-articular therapy.Ann Rheum Dis 1973; 32 Suppl: 3–9.
Bowen BM, Darracott J, Garnett ES, Tomlinson RH. Yttrium-90 citrate colloid for radioisotope synovectomy.Am J Hosp Pharm 1975; 32: 1027–1030.
Shortkroff S, Jones AG, Sledge CB. Radiation synovectomy. In:Advances in metals in medicine. JAI Press; 1993: 155–186.
Noble J, Jones AG, Davis MA, Sledge CB, Kramer RI, Livni E. Leakage of radioactive particle systems from a synovial joint studied with a gamma camera: its application to radiation synovectomy.J Bone Joint Surg [Am] 1983; 65: 381–389.
Sledge CB, Noble J, Hnatowich DJ, Kramer R, Shortkroff S. Experimental radiation synovectomy by 165-Dy ferric hydroxide macroaggregate.Arthritis Rheum 1977; 20: 1334–1342.
Shortkroff S, Mahmood A, Sledge CB, Jones AG, Brodack JW, Chinen LK, Deutsch E, Deutsch KF. Studies on Ho-166-labeled hydroxyapatite: a new agent for radiation synovectomy.J Nucl Med 1992; 33: 937.
Brodack JW, Chinen LK, Deutsch E, Deutsch KF. Studies on the radiolabeling of hydroxyapatite particles for use as radiation synovectomy agents.J Nucl Med 1992; 33: 980.
Johnson LS, Yanch JC. Absorbed dose profiles for radionuclides of frequent use in radiation synovectomy.Arthritis Rheum 1991; 34: 1521–1530.
Nelson WR, Hirayama H, Rogers DWO.The EGS4 code system. Stanford Linear Accelerator Center, 1985.
Hogan OH, Zigman PE, Mackin JL.Beta spectra II. Spectra of individual negatron emitters. United States Radiological Defense Laboratory, 1964.
Jenkins TM, Nelson WR, Rindi A, eds.Monte Carlo transport of electrons and photons. New York: Plenum Press, 1987.
ICRU-44: tissue substitutes in radiation dosimetry and measurement. International Commission on Radiation Units and Measurements, 1989.
Constantinou C.Tissue substitutes for particulate radiations and their use in radiation dosimetry and radiotherapy. PhD thesis, University of London, 1978.
Constantinou C, Attix FH, Paliwal BR. A solid water phantom material for radiotherapy x-ray andγ-ray beam calibrations.Med Phys 1982; 9: 436–441.
Chalkley L, Phototrophy.Chem Rev 1929; 6: 217.
McLaughlin WL, Chalkley L. Measurement of radiation dose distributions with photochromic materials.Radiology 1965; 84: 124.
Humphreys KC, Kantz AD. Radiachromic: a radiation-monitoring system.Radiat Phys Chem 1977; 9: 737–747.
Hnatowich DJ, Kramer RI, Sledge CB, Noble J, Shortkroff S. Dysprosium-165 ferric hydroxide macroaggregates for radiation synovectomy.J Nucl Med 1978; 19: 303–308.
Ansell BM, Crook A, Mallard JR, Bywaters EGL. Evaluation of intra-articular colloidal gold Au-198 in the treatment of persistent knee effusions.Ann Rheum Dis 1963; 22: 435–439.
Husak V, Wiederman M, Kral M. Absorbed dose due to beta-rays from radioactive colloids in radiation synovectomy.Phys Med Biol 1973; 18: 848–854.
Topp JR, Cross EG. The treatment of persistent knee effusions with intra-articular radioactive gold.CMA Journal 1970; 102: 709–714.
Prichard HL, Bridgman JF, Bleehan NM. An investigation of radioactive yttrium (90Y) for the treatment of chronic knee effusions.Br J Rheum 1970; 43: 466–470.
Gumpel JM, Williams ED, Glass HI. Use of yttrium 90 in persistent synovitis of the knee. I. Retention in the knee and spread in the body after injection.Ann Rheum Dis 1973; 32: 223–227.
Gumpel JM, Beer TC, Crawley JC, Farran HE. Yttrium 90 in persistent synovitis of the knee: a single center comparison of four radiocolloids.Br J Radiol 1975; 48: 377–381.
Oka M, Rekonen A, Routsi A, Seppala O. Intra-articular injection of Y-90 resin colloid in the treatment of rheumatoid knee effusions.Acta Rheumatol Scand 1971; 17: 148–160.
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-186 sulphide colloid.Radiobiol Radiother (Berlin) 1979; 3: 363–370.
Virkkunen M, Krusius FE, Keiskanen T. Experiences of intraarticular administration of radioactive gold.Acta Rheumatol Scand 1967; 13: 81–91.
Kyle V, Hazelman BL, Wraight EP. Yttrium-90 therapy and Tc- 99m pertechnetate knee uptake measurements in the management of rheumatoid arthritis.Ann Rheum Dis 1983; 42: 132–137.
Spooren PFMJ, Rasker JJ, Arens RPJH. Synovectomy of the knee with 90Y.Eur J Nucl Med 1985; 10: 441–445.
Will R, Laing B, Edelman J, Lovegrove F, Surveyor I. Comparison of two yttrium-90 regimens in inflammatory and osteoarthropathies.Ann Rheum Dis 1979; 38: 45–47.
ICRP-26: recommendations of the ICRP. International Commission on Radiation Protection, 1977.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Johnson, L.S., Yanch, J.C., Shortkroff, S. et al. Beta-particle dosimetry in radiation synovectomy. Eur J Nucl Med 22, 977–988 (1995). https://doi.org/10.1007/BF00808408
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00808408