title: ¹⁵³Sm-HM for arthritic knee pain. Estimated dosimetry.
abstract: Osteoarthritis is the most common type of arthropathy and after cardiovascular diseases is the most disabling disease in developing countries. The dosimetry for the clinical application of 153-samarium-hydroxymacroaggregates (¹⁵³Sm-HM) for radiation synovectomy (RSV) and palliative treatment for arthritic pain, as far as we know, has not been reported. The aim of this research was to estimate the radiation dose necessary for synovial ablation and pain palliation with minimum risk to the patient. ¹⁵³Sm-HM (370 MBq) was administered intra-articularly in a patient with severe knee pain and hindered motility. Regions of interest drawn on sequential, conjugated, anterior and posterior scintigraphy images were used to obtain the respective activity. The data was entered into a knee joint histological-geometric model designed with micrometric dimensions to represent the synovial cell layers. The Monte Carlo code was used to calculate the absorbed dose in each of the 12 model-cells representing the distance from the synovial liquid to the cartilage or bone. The absorbed dose in the synovial cavity was 114 Gy which is sufficient energy for RSV. The treated patient referred little pain and higher motility with no adverse reactions. ¹⁵³Sm-HM is a potentially valid radiopharmaceutical for RSV, which effectively palliates knee pain.
authors.affiliation: Facultad de Medicina, Universidad Autónoma del Estado de México, Paseo Tollocan s/n, Esquina Jesús Carranza, Colonia Moderna de la Cruz, Toluca, Estado de Mexico, Mexico.
authors.forename: Alberto E
authors.initials: AE
authors.lastname: Hardy-Pérez
authors.forename: Eugenio
authors.initials: E
authors.lastname: Torres-García
authors.forename: Consuelo
authors.initials: C
authors.lastname: Arteaga-de-Murphy
authors.forename: Martha
authors.initials: M
authors.lastname: Pedraza-López
authors.forename: Eleni
authors.initials: E
authors.lastname: Mitsoura
authors.forename: Nallely P
authors.initials: NP
authors.lastname: Jiménez-Mancilla
mesh_terms: D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D009010:Monte Carlo Method; D009942:Organometallic Compounds / Q000008:administration & dosage*; D009943:Organophosphorus Compounds / Q000008:administration & dosage*; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011874:Radiometry / Q000379:methods; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage*
chemical_list: D018712:Analgesics, Non-Narcotic; D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; D019275:Radiopharmaceuticals; C061972:samarium Sm-153 lexidronam