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Oyvind S Bruland - One of the best experts on this subject based on the ideXlab platform.
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high dose Samarium 153 ethylene diamine tetramethylene phosphonate low toxicity of skeletal irradiation in patients with osteosarcoma and bone metastases
Journal of Clinical Oncology, 2002Co-Authors: Peter M Anderson, Gregory A Wiseman, Angela Dispenzieri, Carola A S Arndt, Lynn C Hartmann, William A Smithson, Brian P Mullan, Oyvind S BrulandAbstract:PURPOSE: Samarium-153 ethylene diamine tetramethylene phosphonate (153Sm-EDTMP), a bone-seeking radiopharmaceutical, provides therapeutic irradiation to osteoblastic bone metastases. Because the dose-limiting toxicity of 153Sm-EDTMP is thrombocytopenia, a dose-escalation trial using peripheral-blood progenitor cells (PBPCs) or marrow support was conducted to treat metastatic bone cancer. PATIENTS AND METHODS: Patients with locally recurrent or metastatic osteosarcoma or skeletal metastases avid on bone scan were treated with 1, 3, 4.5, 6, 12, 19, or 30 mCi/kg of 153Sm-EDTMP. RESULTS: Thirty patients were treated with 153Sm-EDTMP. Transient symptoms of hypocalcemia were seen at 30 mCi/kg. Estimates of radioisotope bound to bone surfaces and marrow radiation dose were linear with injected amount of 153Sm-EDTMP. Cytopenias also occurred in all subjects and were dose-related. At day +13 after 153Sm-EDTMP, residual whole-body radioactivity was 1% to 65% of whole-body radioactivity considered safe for PBPC infu...
Peter M Anderson - One of the best experts on this subject based on the ideXlab platform.
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Bone-seeking radiopharmaceuticals as targeted agents of osteosarcoma: Samarium-153-EDTMP and radium-223.
Advances in Experimental Medicine and Biology, 2014Co-Authors: Peter M Anderson, Vivek Subbiah, Eric M. RohrenAbstract:Osteosarcoma is a cancer characterized by formation of bone by malignant cells. Routine bone scan imaging with Tc-99m-MDP is done at diagnosis to evaluate primary tumor uptake and check for bone metastases. At time of relapse the Tc-99m-MDP bone scan also provides a specific means to assess formation of bone by malignant osteosarcoma cells and the potential for bone-seeking radiopharmaceuticals to deliver radioactivity directly into osteoblastic osteosarcoma lesions. This chapter will review and compare a bone-seeking radiopharmaceutical that emits beta-particles, Samarium-153-EDTMP, with an alpha-particle emitter, radium-223. The charged alpha particles from radium-223 have far more mass and energy than beta particles (electrons) from Sm-153-EDTMP. Because radium-223 has less marrow toxicity and more radiobiological effectiveness, especially if inside the bone forming cancer cell than Samarium-153-EDTMP, radium-223 may have greater potential to become widely used against osteosarcoma as a targeted therapy. Radium-223 also has more potential to be used with chemotherapy against osteosarcoma and bone metastases. Because osteosarcoma makes bone and radium-223 acts like calcium, this radiopharmaceutical could possibly become a new targeted means to achieve safe and effective reduction of tumor burden as well as facilitate better surgery and/or radiotherapy for difficult to resect large, or metastatic tumors.
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high dose Samarium 153 ethylene diamine tetramethylene phosphonate low toxicity of skeletal irradiation in patients with osteosarcoma and bone metastases
Journal of Clinical Oncology, 2002Co-Authors: Peter M Anderson, Gregory A Wiseman, Angela Dispenzieri, Carola A S Arndt, Lynn C Hartmann, William A Smithson, Brian P Mullan, Oyvind S BrulandAbstract:PURPOSE: Samarium-153 ethylene diamine tetramethylene phosphonate (153Sm-EDTMP), a bone-seeking radiopharmaceutical, provides therapeutic irradiation to osteoblastic bone metastases. Because the dose-limiting toxicity of 153Sm-EDTMP is thrombocytopenia, a dose-escalation trial using peripheral-blood progenitor cells (PBPCs) or marrow support was conducted to treat metastatic bone cancer. PATIENTS AND METHODS: Patients with locally recurrent or metastatic osteosarcoma or skeletal metastases avid on bone scan were treated with 1, 3, 4.5, 6, 12, 19, or 30 mCi/kg of 153Sm-EDTMP. RESULTS: Thirty patients were treated with 153Sm-EDTMP. Transient symptoms of hypocalcemia were seen at 30 mCi/kg. Estimates of radioisotope bound to bone surfaces and marrow radiation dose were linear with injected amount of 153Sm-EDTMP. Cytopenias also occurred in all subjects and were dose-related. At day +13 after 153Sm-EDTMP, residual whole-body radioactivity was 1% to 65% of whole-body radioactivity considered safe for PBPC infu...
Peter J. Ell - One of the best experts on this subject based on the ideXlab platform.
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Clinical outcome after one year following Samarium-153 particulate hydroxyapatite radiation synovectomy.
Scandinavian Journal of Rheumatology, 2009Co-Authors: Gpr Clunie, D. Lui, Id Cullum, Peter J. Ell, J. C. W. EdwardsAbstract:The clinical outcome and tolerability following treatment with Samarium-153 particulate hydroxyapatite was evaluated in patients with persistent rheumatoid knee synovitis. The clinical review of 18 patients treated with intra-articular Samarium-153 particulate hydroxyapatite combined with triamcinolone hexacetonide who had failed to obtain more than 4 weeks symptom relief from a prior intra-articular glucocorticoid injection was undertaken. No unwanted effects from the treatment were observed. Symptom relief was maintained in 56% patients at 6 months and in 44% of patients at 12 months following treatment. Median duration of symptom relief was 9 months. There was a significantly higher mean baseline Ritchie Articular Index in patients relapsing within 3 months and a trend towards earlier relapse in patients with higher indices of disease activity at the time of treatment. There was a trend towards earlier relapse in patients with a poor range of knee flexion at baseline and with worse indices of intra-articular radiopharmaceutical distribution. Samarium-153 particulate hydroxyapatite knee synovectomy is well tolerated and may be an effective treatment for carefully selected patients with persistent rheumatoid knee synovitis.
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Double blind glucocorticoid controlled trial of Samarium-153 particulate hydroxyapatite radiation synovectomy for chronic knee synovitis.
Annals of the Rheumatic Diseases, 1999Co-Authors: E. K. O'duffy, D. Lui, J. C. W. Edwards, Gavin Clunie, Peter J. EllAbstract:BACKGROUND Samarium-153 particulate hydroxyapatite (Sm-153 PHYP) is a relatively new radiation synovectomy agent developed for the treatment of chronic synovitis. Although it has been shown that the levels of unwanted extra-articular radiation are lower after intra-articular injection of Sm-153 PHYP than yttrium-90 colloid, its clinical efficacy has not been rigorously studied. OBJECTIVES To establish whether Sm-153 PHYP radiation synovectomy results in a clinically useful benefit sustained at one year. METHODS In a randomised double blind study, patients received either intra-articular 40 mg triamcinolone hexacetonide alone or 40 mg triamcinolone hexacetonide combined with Sm-153 PHYP in an outpatient clinic. RESULTS Sixty patients (28 male, 32 female), median age 51 (18–75) with chronic knee synovitis were studied. Diagnoses included: rheumatoid arthritis (n=29); psoriatic arthritis (n=9); ankylosing spondylitis (n=3); reactive arthritis (n=2); undifferentiated seronegative oligoarthritis (n=13) and miscellaneous inflammatory conditions (n=4). More patients who received Sm-153 PHYP/triamcinolone hexacetonide sustained clinical benefit a year after treatment compared with patients who received corticosteroid alone (12 of 31 (39%) v 6 of 29 (21%), a difference of 18% more patients (95% CI −5% to 41%)) though the difference was not significant (χ 2 =2.31, 0.2>p>0.1, n=60). Despite the variation in injected activity (median 563 MBq, range 218–840 MBq), there was no obvious relation between low levels of injected activity ( 2 =2.61, 0.2>p>0.1, n=31). CONCLUSIONS There was no clear beneficial clinical effect of combined Sm-153 PHYP/triamcinolone hexacetonide injection over triamcinolone hexacetonide alone a year after treatment for chronic knee synovitis.
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Chromosomal analysis of peripheral lymphocytes of patients before and after radiation synovectomy with Samarium-153 particulate hydroxyapatite.
Rheumatology, 1999Co-Authors: E. K. O'duffy, J. C. W. Edwards, F. J. Oliver, S. J. Chatters, H. Walker, D. C. Lloyd, Peter J. EllAbstract:Objective. Radiation synovectomy may be indicated for the treatment of chronic synovitis. A number of factors may affect its current use, including availability, limited evidence for its efficacy compared to intra-articular glucocorticoid, and concerns regarding the potential long-term effects of radiation exposure, particularly in younger patients. Specific chromosome-type abnormalities in peripheral lymphocytes can be useful indicators of whole-body radiation exposure. The frequency of these aberrations has been shown to increase in patients who have had radiation synovectomy using yttrium-90 by up to five times compared to baseline levels. Samarium-153 particulate hydroxyapatite (Sm-153 PHYP) is a new radiopharmaceutical currently on trial which appears to have less extra-articular leakage than yttrium-90 compounds. The aim of this study was to identify any increase in specific chromosome-type abnormalities, using published criteria, in patients following Sm-153 PHYP synovectomy of the knee. The 10 patients (five men, five women) in whom the analyses were performed had a mean age of 47 yr (range 28-70 yr). Results. There was no increase in scored chromosome-type abnormalities after Sm-153 PHYP synovectomy. Conclusion. This study further supports the relative safety of Sm-153 PHYP compared to other radiopharmaceuticals.
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Changes in articular synovial lining volume measured by magnetic resonance in a randomized, double-blind, controlled trial of intra-articular Samarium-153 particulate hydroxyapatite for chronic knee synovitis.
Rheumatology, 1999Co-Authors: Gpr Clunie, D. Lui, J. C. W. Edwards, Iain D. Wilkinson, Margaret A. Hall-craggs, Martyn N.j. Paley, Peter J. EllAbstract:Objective. Magnetic resonance techniques have recently been investigated as tools with which to monitor inflammatory joint disease. Our aim was to use a contrast-enhanced T1-weighted protocol to monitor the short-term changes in knee synovial lining volume in a double-blind, randomized, controlled trial of intra-articular Samarium-153 particulate hydroxyapatite (Sm-153 PHYP). Methods. Twenty-four out-patients with chronic knee synovitis, from a cohort who had been recruited to a long-term clinical eYcacy trial, were recruited for this study. Patients received either intra-articular Sm-153 PHYP combined with 40 mg triamcinolone hexacetonide or 40 mg intra-articular triamcinolone hexacetonide alone. Synovial lining volumes were calculated from three-dimensional T1-weighted contrast-enhanced images made before and after contrast enhancement with thresholding and pixel counting, immediately before and 3 months after treatment. Results. Paired pre- and post-treatment magnetic resonance data were obtained for 18/24 (75%) patients. There was no significant diVerence in mean pre-treatment synovial volume between the two treatment groups (139 vs 127 ml ). A mean reduction in synovial lining volume was detected in the Sm-153 PHYP/steroid-treated group (139 to 110 ml, P= 0.07) and in the steroid-treated group (127 to 58 ml, P< 0.001). The reduction was significantly greater in the steroid-treated group (’61% vs ’23%, P< 0.05). Conclusions. Short-term changes in articular synovial lining in response to intra-articular treatment for chronic synovitis may be monitored by magnetic resonance imaging. After 3 months, a greater mean reduction in synovial lining volume had occurred in response to intraarticular steroid alone compared to combined Sm-153 PHYP/steroid injection.
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Samarium-153-Particulate Hydroxyapatite Radiation Synovectomy: Biodistribution Data for Chronic Knee Synovitis
The Journal of Nuclear Medicine, 1995Co-Authors: Gavin Clunie, D. Lui, Id Cullum, J. C. W. Edwards, Peter J. EllAbstract:UNLABELLED Biodistribution data for the radiation synovectomy agent Samarium-153-particulate hydroxyapatite (153Sm-PHYP) are reported. METHODS Mean extra-articular activity accumulation calculated from serial whole-body scans in 13 patients treated for chronic knee synovitis was 0.74% of injected activity (range 0%-3%). RESULTS In four patients (31%), activity was noted in the lung (mean 0.68% of injected activity). In six patients (46%), 0.29% of injected activity accumulated in the regional lymph nodes and in three patients (23%), 0.62% of injected dose accumulated in the liver. Absorbed dose estimates were lung: 14 mGy, regional lymph nodes; 50 mGy, liver; 4 mGy. SPECT demonstrated good distribution of 153Sm-PHYP throughout the anterior knee compartments, although distribution to the posterior compartment was variable. CONCLUSION Distribution is dependent on adequate knee flexion immediately following injection and may be influenced by the size range of labeled particles. Favorable biodistribution data suggest that 153Sm-PHYP is a potentially useful radiation synovectomy agent.
Clara C Chen - One of the best experts on this subject based on the ideXlab platform.
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Samarium 153 edtmp quadramet with or without vaccine in metastatic castration resistant prostate cancer a randomized phase 2 trial
Oncotarget, 2016Co-Authors: Christopher R Heery, Ravi A Madan, Mark N Stein, Walter M Stadler, Robert S Dipaola, Myrna Rauckhorst, Seth M Steinberg, Jennifer L Marte, Clara C ChenAbstract:// Christopher R. Heery 1 , Ravi A. Madan 2 , Mark N. Stein 3 , Walter M. Stadler 4 , Robert S. Di Paola 3, 7 , Myrna Rauckhorst 2 , Seth M. Steinberg 5 , Jennifer L. Marte 2 , Clara C. Chen 6 , Italia Grenga 1 , Renee N. Donahue 1 , Caroline Jochems 1 , William L. Dahut 2 , Jeffrey Schlom 1 , James L. Gulley 2 1 Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 2 Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 3 Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA 4 University of Chicago Medicine, Chicago, IL, USA 5 Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 6 National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA 7 Current affiliation: University of Kentucky College of Medicine Lexington, KY, USA Correspondence to: James L. Gulley, email: Gulleyj@mail.nih.gov Keywords: therapeutic vaccine, radionuclide, prostate cancer, Quadramet ® , cancer immunotherapy Received: April 19, 2016 Accepted: June 26, 2016 Published: July 28, 2016 ABSTRACT PSA-TRICOM is a therapeutic vaccine in late stage clinical testing in metastatic castration-resistant prostate cancer (mCRPC). Samarium-153-ethylene diamine tetramethylene phosphonate (Sm-153-EDTMP; Quadramet ® ), a radiopharmaceutical, binds osteoblastic bone lesions and emits beta particles causing local tumor cell destruction. Preclinically, Sm-153-EDTMP alters tumor cell phenotype facilitating immune-mediated killing. This phase 2 multi-center trial randomized patients to Sm-153-EDTMP alone or with PSA-TRICOM vaccine. Eligibility required mCRPC, bone metastases, prior docetaxel and no visceral disease. The primary endpoint was the proportion of patients without radiographic disease progression at 4 months. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and immune responses. Forty-four patients enrolled. Eighteen and 21 patients were evaluable for the primary endpoint in Sm-153-EDTMP alone and combination arms, respectively. There was no statistical difference in the primary endpoint, with two of 18 (11.1%) and five of 21 (23.8%) in Sm-153-EDTMP alone and combination arms, respectively, having stable disease at approximately the 4-month evaluation time point ( P = 0.27). Median PFS was 1.7 vs. 3.7 months in the Sm-153-EDTMP alone and combination arms ( P = 0.041, HR = 0.51, P = 0.046). No patient in the Sm-153-EDTMP alone arm achieved prostate-specific antigen (PSA) decline > 30% compared with four patients (of 21) in the combination arm, including three with PSA decline > 50%. Toxicities were similar between arms and related to number of Sm-153-EDTMP doses administered. These results provide the rationale for clinical evaluation of new radiopharmaceuticals, such as Ra-223, in combination with PSA-TRICOM.
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Samarium-153-EDTMP (Quadramet ® ) with or without vaccine in metastatic castration-resistant prostate cancer: A randomized Phase 2 trial
Oncotarget, 2016Co-Authors: Christopher R Heery, Ravi A Madan, Mark N Stein, Walter M Stadler, Robert S Dipaola, Myrna Rauckhorst, Seth M Steinberg, Jennifer L Marte, Clara C Chen, Italia GrengaAbstract:// Christopher R. Heery 1 , Ravi A. Madan 2 , Mark N. Stein 3 , Walter M. Stadler 4 , Robert S. Di Paola 3, 7 , Myrna Rauckhorst 2 , Seth M. Steinberg 5 , Jennifer L. Marte 2 , Clara C. Chen 6 , Italia Grenga 1 , Renee N. Donahue 1 , Caroline Jochems 1 , William L. Dahut 2 , Jeffrey Schlom 1 , James L. Gulley 2 1 Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 2 Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 3 Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA 4 University of Chicago Medicine, Chicago, IL, USA 5 Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 6 National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA 7 Current affiliation: University of Kentucky College of Medicine Lexington, KY, USA Correspondence to: James L. Gulley, email: Gulleyj@mail.nih.gov Keywords: therapeutic vaccine, radionuclide, prostate cancer, Quadramet ® , cancer immunotherapy Received: April 19, 2016 Accepted: June 26, 2016 Published: July 28, 2016 ABSTRACT PSA-TRICOM is a therapeutic vaccine in late stage clinical testing in metastatic castration-resistant prostate cancer (mCRPC). Samarium-153-ethylene diamine tetramethylene phosphonate (Sm-153-EDTMP; Quadramet ® ), a radiopharmaceutical, binds osteoblastic bone lesions and emits beta particles causing local tumor cell destruction. Preclinically, Sm-153-EDTMP alters tumor cell phenotype facilitating immune-mediated killing. This phase 2 multi-center trial randomized patients to Sm-153-EDTMP alone or with PSA-TRICOM vaccine. Eligibility required mCRPC, bone metastases, prior docetaxel and no visceral disease. The primary endpoint was the proportion of patients without radiographic disease progression at 4 months. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and immune responses. Forty-four patients enrolled. Eighteen and 21 patients were evaluable for the primary endpoint in Sm-153-EDTMP alone and combination arms, respectively. There was no statistical difference in the primary endpoint, with two of 18 (11.1%) and five of 21 (23.8%) in Sm-153-EDTMP alone and combination arms, respectively, having stable disease at approximately the 4-month evaluation time point ( P = 0.27). Median PFS was 1.7 vs. 3.7 months in the Sm-153-EDTMP alone and combination arms ( P = 0.041, HR = 0.51, P = 0.046). No patient in the Sm-153-EDTMP alone arm achieved prostate-specific antigen (PSA) decline > 30% compared with four patients (of 21) in the combination arm, including three with PSA decline > 50%. Toxicities were similar between arms and related to number of Sm-153-EDTMP doses administered. These results provide the rationale for clinical evaluation of new radiopharmaceuticals, such as Ra-223, in combination with PSA-TRICOM.
J. C. W. Edwards - One of the best experts on this subject based on the ideXlab platform.
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Clinical outcome after one year following Samarium-153 particulate hydroxyapatite radiation synovectomy.
Scandinavian Journal of Rheumatology, 2009Co-Authors: Gpr Clunie, D. Lui, Id Cullum, Peter J. Ell, J. C. W. EdwardsAbstract:The clinical outcome and tolerability following treatment with Samarium-153 particulate hydroxyapatite was evaluated in patients with persistent rheumatoid knee synovitis. The clinical review of 18 patients treated with intra-articular Samarium-153 particulate hydroxyapatite combined with triamcinolone hexacetonide who had failed to obtain more than 4 weeks symptom relief from a prior intra-articular glucocorticoid injection was undertaken. No unwanted effects from the treatment were observed. Symptom relief was maintained in 56% patients at 6 months and in 44% of patients at 12 months following treatment. Median duration of symptom relief was 9 months. There was a significantly higher mean baseline Ritchie Articular Index in patients relapsing within 3 months and a trend towards earlier relapse in patients with higher indices of disease activity at the time of treatment. There was a trend towards earlier relapse in patients with a poor range of knee flexion at baseline and with worse indices of intra-articular radiopharmaceutical distribution. Samarium-153 particulate hydroxyapatite knee synovectomy is well tolerated and may be an effective treatment for carefully selected patients with persistent rheumatoid knee synovitis.
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Double blind glucocorticoid controlled trial of Samarium-153 particulate hydroxyapatite radiation synovectomy for chronic knee synovitis.
Annals of the Rheumatic Diseases, 1999Co-Authors: E. K. O'duffy, D. Lui, J. C. W. Edwards, Gavin Clunie, Peter J. EllAbstract:BACKGROUND Samarium-153 particulate hydroxyapatite (Sm-153 PHYP) is a relatively new radiation synovectomy agent developed for the treatment of chronic synovitis. Although it has been shown that the levels of unwanted extra-articular radiation are lower after intra-articular injection of Sm-153 PHYP than yttrium-90 colloid, its clinical efficacy has not been rigorously studied. OBJECTIVES To establish whether Sm-153 PHYP radiation synovectomy results in a clinically useful benefit sustained at one year. METHODS In a randomised double blind study, patients received either intra-articular 40 mg triamcinolone hexacetonide alone or 40 mg triamcinolone hexacetonide combined with Sm-153 PHYP in an outpatient clinic. RESULTS Sixty patients (28 male, 32 female), median age 51 (18–75) with chronic knee synovitis were studied. Diagnoses included: rheumatoid arthritis (n=29); psoriatic arthritis (n=9); ankylosing spondylitis (n=3); reactive arthritis (n=2); undifferentiated seronegative oligoarthritis (n=13) and miscellaneous inflammatory conditions (n=4). More patients who received Sm-153 PHYP/triamcinolone hexacetonide sustained clinical benefit a year after treatment compared with patients who received corticosteroid alone (12 of 31 (39%) v 6 of 29 (21%), a difference of 18% more patients (95% CI −5% to 41%)) though the difference was not significant (χ 2 =2.31, 0.2>p>0.1, n=60). Despite the variation in injected activity (median 563 MBq, range 218–840 MBq), there was no obvious relation between low levels of injected activity ( 2 =2.61, 0.2>p>0.1, n=31). CONCLUSIONS There was no clear beneficial clinical effect of combined Sm-153 PHYP/triamcinolone hexacetonide injection over triamcinolone hexacetonide alone a year after treatment for chronic knee synovitis.
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Chromosomal analysis of peripheral lymphocytes of patients before and after radiation synovectomy with Samarium-153 particulate hydroxyapatite.
Rheumatology, 1999Co-Authors: E. K. O'duffy, J. C. W. Edwards, F. J. Oliver, S. J. Chatters, H. Walker, D. C. Lloyd, Peter J. EllAbstract:Objective. Radiation synovectomy may be indicated for the treatment of chronic synovitis. A number of factors may affect its current use, including availability, limited evidence for its efficacy compared to intra-articular glucocorticoid, and concerns regarding the potential long-term effects of radiation exposure, particularly in younger patients. Specific chromosome-type abnormalities in peripheral lymphocytes can be useful indicators of whole-body radiation exposure. The frequency of these aberrations has been shown to increase in patients who have had radiation synovectomy using yttrium-90 by up to five times compared to baseline levels. Samarium-153 particulate hydroxyapatite (Sm-153 PHYP) is a new radiopharmaceutical currently on trial which appears to have less extra-articular leakage than yttrium-90 compounds. The aim of this study was to identify any increase in specific chromosome-type abnormalities, using published criteria, in patients following Sm-153 PHYP synovectomy of the knee. The 10 patients (five men, five women) in whom the analyses were performed had a mean age of 47 yr (range 28-70 yr). Results. There was no increase in scored chromosome-type abnormalities after Sm-153 PHYP synovectomy. Conclusion. This study further supports the relative safety of Sm-153 PHYP compared to other radiopharmaceuticals.
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Changes in articular synovial lining volume measured by magnetic resonance in a randomized, double-blind, controlled trial of intra-articular Samarium-153 particulate hydroxyapatite for chronic knee synovitis.
Rheumatology, 1999Co-Authors: Gpr Clunie, D. Lui, J. C. W. Edwards, Iain D. Wilkinson, Margaret A. Hall-craggs, Martyn N.j. Paley, Peter J. EllAbstract:Objective. Magnetic resonance techniques have recently been investigated as tools with which to monitor inflammatory joint disease. Our aim was to use a contrast-enhanced T1-weighted protocol to monitor the short-term changes in knee synovial lining volume in a double-blind, randomized, controlled trial of intra-articular Samarium-153 particulate hydroxyapatite (Sm-153 PHYP). Methods. Twenty-four out-patients with chronic knee synovitis, from a cohort who had been recruited to a long-term clinical eYcacy trial, were recruited for this study. Patients received either intra-articular Sm-153 PHYP combined with 40 mg triamcinolone hexacetonide or 40 mg intra-articular triamcinolone hexacetonide alone. Synovial lining volumes were calculated from three-dimensional T1-weighted contrast-enhanced images made before and after contrast enhancement with thresholding and pixel counting, immediately before and 3 months after treatment. Results. Paired pre- and post-treatment magnetic resonance data were obtained for 18/24 (75%) patients. There was no significant diVerence in mean pre-treatment synovial volume between the two treatment groups (139 vs 127 ml ). A mean reduction in synovial lining volume was detected in the Sm-153 PHYP/steroid-treated group (139 to 110 ml, P= 0.07) and in the steroid-treated group (127 to 58 ml, P< 0.001). The reduction was significantly greater in the steroid-treated group (’61% vs ’23%, P< 0.05). Conclusions. Short-term changes in articular synovial lining in response to intra-articular treatment for chronic synovitis may be monitored by magnetic resonance imaging. After 3 months, a greater mean reduction in synovial lining volume had occurred in response to intraarticular steroid alone compared to combined Sm-153 PHYP/steroid injection.
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Samarium-153-Particulate Hydroxyapatite Radiation Synovectomy: Biodistribution Data for Chronic Knee Synovitis
The Journal of Nuclear Medicine, 1995Co-Authors: Gavin Clunie, D. Lui, Id Cullum, J. C. W. Edwards, Peter J. EllAbstract:UNLABELLED Biodistribution data for the radiation synovectomy agent Samarium-153-particulate hydroxyapatite (153Sm-PHYP) are reported. METHODS Mean extra-articular activity accumulation calculated from serial whole-body scans in 13 patients treated for chronic knee synovitis was 0.74% of injected activity (range 0%-3%). RESULTS In four patients (31%), activity was noted in the lung (mean 0.68% of injected activity). In six patients (46%), 0.29% of injected activity accumulated in the regional lymph nodes and in three patients (23%), 0.62% of injected dose accumulated in the liver. Absorbed dose estimates were lung: 14 mGy, regional lymph nodes; 50 mGy, liver; 4 mGy. SPECT demonstrated good distribution of 153Sm-PHYP throughout the anterior knee compartments, although distribution to the posterior compartment was variable. CONCLUSION Distribution is dependent on adequate knee flexion immediately following injection and may be influenced by the size range of labeled particles. Favorable biodistribution data suggest that 153Sm-PHYP is a potentially useful radiation synovectomy agent.
