确定最合适的放射性核素用于膝关节放射滑膜切除术：评估辐射剂量、辐射致癌风险和治疗后影像学可行性。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics Pub Date : 2025-02-01 DOI:10.1016/j.ejmp.2025.104903

Roghiyeh Bodaghi , Babak Mahmoudian , Hadi Rezaei , Asra Sadat Talebi

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引用次数: 0

摘要

目的：本研究旨在系统评估迄今为止用于膝关节RSV的所有放射性核素，并确定最适合用于膝关节RSV的放射性核素：方法：将膝关节RSV与Y-90、P-32、Ho-166、Re-188、Au-198、Lu-177、Sm-153和Re-186进行比较，测量膝关节RSV患者非靶器官的辐射剂量和诱发继发性恶性肿瘤的剂量、膝关节RSV患者家属和医务人员的辐射剂量以及治疗后的图像质量：结果：与膝关节RSV使用的其他放射性核素相比，Y-90和P-32在成人和儿童患者中的癌症发病率和死亡率的终生可归属风险以及实体癌发病率和死亡率的相对风险都明显较高。使用 Re-188、Ho-166、Au-198 和 Sm-153 的膝关节 RSV 诱发继发性恶性肿瘤的风险微乎其微。医务人员和家属接触接受 Y-90 治疗的患者的平均吸收剂量也明显高于接触接受其他放射性核素治疗的 RSV 患者的平均吸收剂量。相比之下，接受 Sm-153、Ho-166 和 Au-198 治疗的 RSV 患者的医务人员和家属的吸收剂量可以忽略不计。Sm-153、Ho-166 和 Re-188 可在 RSV 后平面成像中提供高质量的图像：根据这项研究的结果和放射性核素的治疗范围，Re-188 已被确定为替代 Y-90 用于成人膝关节 RSV 的合适选择。同时，Sm-153 和 Ho-166 被认为是最适合用于小儿膝关节 RSV 的放射性核素。

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Determination of the most appropriate radionuclide for knee radiosynovectomy: Assessment of radiation dose, radiation-induced cancer risk, and post-treatment imaging feasibility

Purpose

This study aims to systematically evaluate all radionuclides used in knee RSV to date and identify the most suitable radionuclide for knee RSV.

Methods

To compare knee RSV with Y-90, P-32, Ho-166, Re-188, Au-198, Lu-177, Sm-153, and Re-186, we measured the radiation dose to non-target organs and the inducing of secondary malignancies in knee RSV patient, the radiation dose to family member and medical staff from the knee RSV patients, and the quality of post-treatment images.

Results

The Lifetime Attributable Risks of cancer incidence and mortality and the Relative Risks of solid cancer incidence and mortality are significantly higher for Y-90 and P-32 in both adult and pediatric patients compared to other radionuclides used in knee RSV. Knee RSV with Re-188, Ho-166, Au-198, and Sm-153 induces a negligible risk of secondary malignancies. The average absorbed dose for medical staff and family members exposed to patients treated with Y-90 is also significantly greater than for those exposed to RSV patients treated with other radionuclides. In contrast, the absorbed dose for medical staff and family members exposed to RSV patients treated with Sm-153, Ho-166, and Au-198 is negligible. Sm-153, Ho-166, and Re-188 offer high-quality images in post-RSV planar imaging.

Conclusion

Based on the findings of this study and the therapeutic range of the radionuclides, Re-188 has been identified as a suitable alternative to Y-90 for knee RSV in adults. At the same time, Sm-153 and Ho-166 have been recognized as the most appropriate radionuclides for pediatric knee RSV.

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来源期刊

Physica Medica-European Journal of Medical Physics 生物-生物物理

CiteScore

6.80

自引率

14.70%

发文量

493

审稿时长

78 days

期刊介绍： Physica Medica, European Journal of Medical Physics, publishing with Elsevier from 2007, provides an international forum for research and reviews on the following main topics: Medical Imaging Radiation Therapy Radiation Protection Measuring Systems and Signal Processing Education and training in Medical Physics Professional issues in Medical Physics.