Abstract
Radiosynovectomy is a novel method of treatment for several acute and chronic inflammatory joint disorders. A small amount of a beta-emitting radionuclide is injected into the affected joint delivering a radiation dose of 70 to 100 Gy to the synovia. The proliferative tissue is destroyed, secretion of fluid and accumulation of inflammation causing cellular compounds stops and the joint surfaces become fibrosed, providing long term symptom relief. The radionuclides are injected in colloidal form so that they remain in the synovium and are not transported by lymphatic vessels causing radiation exposure to other organs. Complete reduction of knee joint swelling has been seen in above 40% and pain relief in 88% of patients. Wrist, elbow, shoulder, ankle and hip joints showed significant improvement in 50-60% and restoration of normal function and long term pain relief has been achieved in about 70% of small finger joints. In hemophilic arthropathies complete cessation of bleeding in about 60% and improved mobility in 75% of patients has been reported.
Highlights
Intensity modulated radiotherapy (IMRT) utilises small beamlets of ionising radiation to provide a highKhamfongkhruea et al Biomed Imaging Interv J 2012; 8(1):e5This page number is not for citation purposes use a respiratory gating system
The measurements by MapCheck show the gamma index of the planned absolute dose distribution in static and moving targets with gating, resulting in more than 96% passing for all dose rates
The absolute dose distribution measured by film for the static target was agreeable with the value of moving target with gating
Summary
Intensity modulated radiotherapy (IMRT) utilises small beamlets of ionising radiation to provide a highKhamfongkhruea et al Biomed Imaging Interv J 2012; 8(1):e5This page number is not for citation purposes use a respiratory gating system. Chen et al [5] studied the dosimetric effects caused by the respiratory motion during IMRT by using Kodak EDR2 films. They concluded that, without the gating system, the dose distribution of the stationary phantom was different from the moving one. Duan et al [7] studied the dosimetric effect of respiration-gated beam with IMRT delivery Their results suggested that low dose rate can reduce the effect of delay and catch-up cycle. Lin et al [2] determined the effect of radiation dose rate with moving target and the gated treatment using step-and-shoot IMRT delivery. The high dose rate gated stepand-shoot IMRT was dosimetrically accurate, shortened the delivery time, and was safe to use clinically
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