Bielińska A, Korkosz M, Gąsowski J, Tomaszuk M, Staszczak-Sowa A, Kwaśny-Krochin B, Buziak-Bereza M, Hubalewska-Dydejczyk A, Grodzicki T
Department of Rheumatology and Balneology, Jagiellonian University Medical College, Sniadeckich 10, 31-501, Kraków, Poland,
Ann Nucl Med. 2014 Aug;28(7):688-92. doi: 10.1007/s12149-014-0827-8. Epub 2014 Mar 5.
To examine yttrium-90 distribution 1 and 72 h following its injection into a knee joint in patients with rheumatoid arthritis (RA).
In 14 RA patients we injected yttrium-90 into the affected knee joint using lateral approach. To assess the radioisotope distribution in the joint, the superimposed sequential SPECT and CT imaging was performed 1 and 72 h after the injection. We analyzed the percentage of radioisotope distribution in three predefined compartments of the knee joint (lower, upper medial, upper lateral).
After 1 and 72 h, the mean percentage distributions were, respectively, 7.14 and 23.07% in lower; 21.42 and 15.38% in upper medial, and 71.42 and 61.53% in upper lateral compartment. The percentage of isotope deposition did not change significantly with time in any of the compartments (all p > 0.26). The deposition of isotope, both at 1 and 72 h, was significantly greater in upper lateral compartment, where the injection was performed, than in all other compartments (all p < 0.05).
Using the SPECT/CT hybrid method, we proved that the majority of isotope is located at the compartment adjacent to the injection. Two injections targeting different compartments might improve the clinical efficacy of the procedure.
研究类风湿关节炎（RA）患者膝关节注射钇-90后1小时和72小时的分布情况。
对14例RA患者采用外侧入路将钇-90注入患侧膝关节。为评估关节内放射性同位素的分布，在注射后1小时和72小时进行叠加的序列单光子发射计算机断层扫描（SPECT）和计算机断层扫描（CT）成像。我们分析了膝关节三个预定义区域（下部、上部内侧、上部外侧）放射性同位素分布的百分比。
1小时和72小时后，下部区域的平均分布百分比分别为7.14%和23.07%；上部内侧区域分别为21.42%和15.38%；上部外侧区域分别为71.42%和61.53%。在任何一个区域，同位素沉积百分比均未随时间发生显著变化（所有p>0.26）。在1小时和72小时时，注射部位所在的上部外侧区域的同位素沉积均显著高于所有其他区域（所有p<0.05）。
使用SPECT/CT混合方法，我们证明大部分同位素位于注射部位附近的区域。针对不同区域进行两次注射可能会提高该治疗方法的临床疗效。
