Sarwal Tanvi, Kumar Rajesh, Taywade Sameer, Elhence Abhay, Gopalakrishnan Maya, Didel Siyaram, Gaur Ravi
Department of Nuclear Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Eur J Nucl Med Mol Imaging. 2025 Aug 12. doi: 10.1007/s00259-025-07496-5.
To determine the efficacy of [Lu]Lu-Hydroxyapatite radiosynovectomy (RSV) in patients with refractory chronic inflammatory arthritis of the knee joint.
Overall, 24 knees in 22 patients with refractory chronic inflammatory arthritis were enrolled in this prospective study. All patients were assessed clinically for pain, tenderness, range of motion, analgesic intake, Oxford Knee Score, and scintigraphically based on blood pool activity on three-phase bone scan. Various scores were assigned to clinical these parameters. RSV of the knee joint was done using intra-articular injection of [Lu]Lu-Hydroxyapatite. Patients were assessed clinically at 1 and 3 months, and scintigraphically at 3 months using blood pool index on three-phase bone scan. Patients were categorised as responders and non-responders on the basis of change in percentage of cumulative scores.
Out of 24 knees, 18 knees were responders and 6 knees were non-responders at 3 months. There was a significant improvement in clinical scores at 1 month post-RSV, which persisted at 3 months post-RSV (p < 0.05). However, the change in blood pool activity on three-phase bone scan was not significant. Reported adverse effects were mild and not significant.
This study confirmed the safety and efficacy of [Lu]Lu-Hydroxyapatite radiosynovectomy for patients with chronic inflammatory knee joint arthritis refractory to conventional medical treatment.
确定[镥]镥-羟基磷灰石放射性滑膜切除术（RSV）对难治性膝关节慢性炎症性关节炎患者的疗效。
本前瞻性研究共纳入22例难治性慢性炎症性关节炎患者的24个膝关节。所有患者均接受临床评估，包括疼痛、压痛、活动范围、镇痛药摄入量、牛津膝关节评分，并基于三相骨扫描的血池活性进行闪烁扫描评估。为这些临床参数分配了各种评分。膝关节RSV通过关节内注射[镥]镥-羟基磷灰石进行。在1个月和3个月时对患者进行临床评估，并在3个月时使用三相骨扫描的血池指数进行闪烁扫描评估。根据累积评分百分比的变化将患者分为反应者和无反应者。
24个膝关节中，3个月时18个膝关节为反应者，6个膝关节为无反应者。RSV后1个月临床评分有显著改善，RSV后3个月仍持续改善（p < 0.05）。然而，三相骨扫描血池活性的变化不显著。报告的不良反应轻微且不显著。
本研究证实了[镥]镥-羟基磷灰石放射性滑膜切除术对传统药物治疗难治的慢性炎症性膝关节关节炎患者的安全性和有效性。
