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

Author(s):Show less -

Santos, Allan O. ^[1] ; Ricciardi, Janaina B. S. ^[2] ; Pagnano, Rodrigo ^[3] ; Pereira, Luis Fernando M. ^[1] ; Sakuma, Emerson T. ^[4] ; Matsuda, Margareth M. N. ^[5] ; Bernardes, Emerson S. ^[5] ; Araujo, Elaine B. ^[5] ; Brunetto, Sergio Q. ^[6] ; Takahashi, Maria Emilia S. ^[7] ; Brunetto, Edna M. ^[1] ; Zulli, Roberto ^[2] ; Ozelo, Margareth C. ^[2] ; Etchebehere, Elba C. S. C. ^[1]

Affiliation

^[1] Univ Campinas UNICAMP, Dept Radiol, Div Nucl Med, Campinas - Brazil

^[2] Univ Campinas UNICAMP, Hemoctr UNICAMP, Hemophilia Unit, Campinas - Brazil

^[3] Univ Campinas UNICAMP, Dept Surg, Dept Orthoped & Traumatol, Campinas - Brazil

^[4] Univ Campinas UNICAMP, Dept Radiol, Div Ultrasound, Campinas - Brazil

^[5] Nucl & Energy Res Inst IPEN CNEN, Radiopharm Ctr, Sao Paulo - Brazil

^[6] Univ Estadual Campinas, Ctr Biomed Engn, Campinas - Brazil

^[7] Univ Estadual Campinas, Gleb Wataghin Phys Inst, Campinas - Brazil

• Document type: Journal article
• Source: ANNALS OF NUCLEAR MEDICINE; v. 35, n. 2 JAN 2021.
• Web of Science Citations: 0

Abstract

Introduction Radiosynovectomy (RS) with Y-90-hydroxyapatite (Y-90-HyA) aims to control knee hemarthrosis in hemophiliac patients to prevent secondary arthropathy. However, knee RS using Sm-153-hydroxyapatite (Sm-153-HyA) is considered less suitable due to the lower average soft tissue range and energy of Sm-153 for large joints, such as the knees. Purpose The objective of this investigation was to assess the efficacy and safety of knee RS with Sm-153-HyA, compared to Y-90-HyA. Methods Forty patients were prospectively assigned to undergo knee RS with Sm-153-HyA (n = 19) or with Y-90-HyA (n = 21). The frequency of hemarthrosis episodes before and after treatment were compared. Results After six months of knee RS, Sm-153-HyA and Y-90-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 Sm-153-HyA (87.5%) compared to Y-90-HyA (50.0%). This discrepancy was more pronounced (p = 0.002) for Sm-153-HyA compared to Y-90-HyA in adults/adolescents. Conclusion Knee radiosynovectomy with Sm-153-HyA is safe, reduces hemarthrosis episodes after 12 months of treatments, especially in adults/adolescents and even with grades III/IV arthropathy, similar to Y-90-HyA. Y-90-HyA seems to promote better hemarthrosis control in small children. (AU)

• FAPESP's process: 13/05255-7 - Evaluation of safety and efficacy of radiosynovectomy with 153-samarium-hydroxyapatite in patients with hemophilia
• Grantee: ALLAN DE OLIVEIRA SANTOS
• Support Opportunities: Regular Research Grants