RADIATION SYNOVECTOMY REVISITED

Radiation synovectomy is a potential weapon in the therapeutic armamen tarium of nuclear medicine. It is an attractive alternative to surgica l or chemical synovectomy for the treatment of rheumatoid arthritis. I n this article the clinical results obtained with radiation synovectom y from the 1950s through 1992 are summarized and reviewed. Even after taking into account the paucity of well-controlled trials and rigorous clinical follow-up, it is clear that radiation synovectomy is efficac ious in controlling the symptoms of rheumatoid arthritis. However, the procedure is not widely used because of concerns about leakage of rad ioactivity from the treated joint, and the resulting high doses that c an be delivered to nontarget organs. New approaches to the preparation of radiolabeled particles for use in radiation synovectomy promise to minimize this leakage and thus allow the full potential of this impor tant radiotherapy to be realized.