Distribution of radiation in synovectomy of the knee with 166Ho-FHMA using image fusion.
BACKGROUND: Radiation synovectomy is an effective technique for the treatment of chronic synovitis in patients with rheumatoid arthritis ( RA), and is an alternative for surgical synovectomy. Holmium ferric hydroxide macroaggregates (166Ho-FHMA) is suitable for radiation synovectomy, especially because it emits high-energy beta particles and a smaller proportion of low-energy photons that are suitable for gamma-camera imaging. OBJECTIVE: The aim of this study was to develop a method to fuse 166Ho-FHMA single photon emission computed tomography (SPECT) and magnetic resonance (MRI) images, to show the distribution of 166Ho-FHMA inside the joint with images that localize synovitis. METHODS: The knees of 6 patients with RA were treated with 166Ho-FHMA. (99m)Tc-human immunoglobulin ((99m)Tc-HIG) SPECT images and MRI images were taken before 166Ho-FHMA injections. 166Ho-FHMA SPECT images were taken 4, 28, and 40 hours after injections. SPECT and MRI images were merged using a specific image fusion method, called mutual information algorithm, to study associations between anatomical and metabolic information from these images. RESULTS: Fusion of SPECT and MRI images indicated that intensity of radioactivity was associated with the amount of synovitis. Activity distribution of 166Ho-FHMA could be registered using anatometabolic images. CONCLUSIONS: A new method to fuse the distribution of radiation in the synovectomy of the knee was developed using SPECT/MRI image registration. Image registration of SPECT and MRI can be used to determine the activity distribution of radioisotopes in relation to synovitis.[1]References
- Distribution of radiation in synovectomy of the knee with 166Ho-FHMA using image fusion. Vuorela, J., Kauppinen, T., Sokka, T. Cancer Biother. Radiopharm. (2005) [Pubmed]
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