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A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413
Online ISSN 1827-1936
Schweeger I., Pirich C., Ofluoglu S., Sinzinger H.
Department of Nuclear Medicine University of Vienna, Vienna, Austria
Aim. Leakage is of major concern when performing radiation synovectomy. Although post-treatment immobilization was provided, extra-articular leakage of radioactivity has occasionally been observed in patients receiving local anesthesia in the course of radiation synovectomy. This study was performed to uncover any unfavourable effect of lidocaine on stability of 166Ho-FHMA (ferrum hydroxide macroaggregate).
Methods. The radiopharmaceutical was investigated in bovine serum albumin (BSA) solutions (5, 10 mg/ml) at pH 6, 7 and 8. Furthermore, the tracer was incubated for 0, 2, 24, 48 and 120 hours in synovial fluid. In both series the influence of lidocaine-HCl 2% (500, 1000 µl) has been evaluated.
Results. In BSA test solutions, amount of lidocaine added [df(2), F=7.82, p-level: 0.00] and pH [df(2), F=7.82, p-level: 0.00] significantly influenced in vitro stability of 166Ho labeled FHMA (n=72). This finding was confirmed in synovial fluid [df(2), F=3.82, p-level: 0.03] (n=60).
Conclusion. In an experimental design mimicking normal and inflammatory conditions in the joint, addition of a few milliliters of lidocaine-HCl followed by a shift towards lower pH-values in synovial fluid may endanger stability of the carrier-tracer complex 166Ho-FHMA and thereby enhance extra-articular leakage.