Radionucide and vehicle as well as radiation synovectomy / 中国组织工程研究

ABSTRACT

OBJECTIVE: To investigate the selections of radionucide and vehicle and the indications, contraindications, complications and cautions of radiation synovectomy in clinical applications; meanwhile, to provide valuable references for clinical application of radiation synovectomy.DATA SOURCES Of 277 articles which have the word "radiation synovectomy" or "radiosynovectomy" were searched out from PubMed database without limitations.STUDY SELECTION All the titles and most abstracts of the articles were reviewed. A total of 58 articles were selected by the standard of having close relations with radionucide, vehicle and radiation synovectomy. Then the full texts were searched in other available databases, especially in "OVID" and "ScienceDirect".DATA EXTRACTION The last articles and articles published in authority journals were chosen for further read, and 41 articles were obtained.DATA SYNTHESIS: Recently, the hot topic of radionucide is detailed as follows Firstly, selection of vehicle. Till now, silicate, citrate, Ca oxalate, ferric hydroxide macroaggregate (FHMA), hydroxyapatite (HA), polylactic acid (PLA), sulfur colloids, microspheres, etc. Have been the most widely used vehicles. The usage of a good vehicle is to control the size and stability of the radiopharmaceutical, and decrease its leakage from the joint. Secondly, it should contain radiopharmaceuticals of nuclein and vehicle. An ideal radiolabeled radiopharmaceutical for radiation synovectomy should meet the following requirements ① it should be sufficiently small to be phagocytized, but not so small that it might leak from the joint before being phagocytized, the appropriate size range is usually considered to be from 2 to 10 μm; ② the binding between the radionuclide and the vehicle should be irreversible throughout the course of the radiotherapy, which, in turn, is determined by the physical half-life of the radionuclide; ③ the radiolabeled particles should be distributed homogeneously in the joint without initiating an inflammatory response; ④ the half-life of the vehicle should be longer than that of the nuclide it combines,and the vehicle should be biodegradable, so that it can be eliminated out of the body after therapy; ⑤ good stability and low cost are also very important features. Thirdly, Radiation synovectomy is an effective method to treat chronic arthritis.CONCLUSION: With careful nuclide and indication selection and correct operation, radiation synovectomy is a clinically useful, safe, and cost-effective outpatient procedure in the treatment for many kinds of joint disease.