Klett R, Schnurbus-Duhs A, Mödder G, Schmid E, Voth M
Nuclear medicine practice, Paul-Zipp-Strasse 171-173, 35398 Giessen, Germany.
Nuklearmedizin. 2012;51(1):17-25. doi: 10.3413/nukmed-0423-11-08. Epub 2011 Sep 20.
Radiosynoviorthesis (RSO) with the nuclides rhenium-186 sulphide (186Re) and erbium-169 citrate (169Er) is an established concept for the treatment of persistent synovitis of medium and small sized joints. THE AIM of the present studies was to investigate the biological radiation effect based on analysing chromosome aberrations.
PATIENTS, METHODS: Immediately before and 17 to 19 days (186Re) or 45 to 50 (169Er) days after RSO with 186Re or 169Er colloid and subsequent immobilisation of the treated joint, blood samples of a total of 23 patients were collected. The yield of dicentric chromosomes in lymphocytes was determined exclusively in metaphases of the first cell cycle in vitro. In addition, for 186Re the activity leakage was measured three days after RSO by whole-body scintigraphy.
No statistically significant increase in the number of dicentric chromosomes (40 and 88 before and 59 and 105 after treatment with 186Re and 169Er, respectively) in a total of 47017 cells analysed from 46 blood samples could be found as a result of RSO. For 186Re an activity leakage of 3.9%±7% with a maximum of 23.4% corresponding to an effective dose of 2.8±4.5 mSv , respectively 13.8 mSv, was determined. Also in the case of the maximum leakage no significant increase of dicentric chromosomes were detected.
No significant biological radiation effect can be detected after RSO with 186Re and 169Er, also in cases of high leakage. Therefore, RSO can be classified as a save therapeutic procedure without a relevant radiation risk.
使用硫化铼-186（186Re）和柠檬酸铒-169（169Er）核素进行放射性滑膜切除术（RSO）是治疗中小关节持续性滑膜炎的既定概念。本研究的目的是通过分析染色体畸变来研究生物辐射效应。
患者、方法：在使用186Re或169Er胶体进行RSO并随后固定治疗关节之前以及之后17至19天（186Re）或45至50天（169Er），收集了总共23名患者的血样。仅在体外第一个细胞周期的中期测定淋巴细胞中双着丝粒染色体的产量。此外，对于186Re，在RSO后三天通过全身闪烁扫描测量活性泄漏。
在从46份血样中分析的总共47017个细胞中，未发现因RSO导致双着丝粒染色体数量有统计学上的显著增加（186Re和169Er治疗前分别为40和88，治疗后分别为59和105）。对于186Re，测定的活性泄漏为3.9%±7%，最大值为23.4%，分别对应有效剂量2.8±4.5 mSv和13.8 mSv。即使在最大泄漏的情况下，也未检测到双着丝粒染色体的显著增加。
使用186Re和169Er进行RSO后，即使在高泄漏情况下，也未检测到显著的生物辐射效应。因此，RSO可归类为一种安全的治疗方法，不存在相关辐射风险。
