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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
Rivista di Medicina Nucleare e Imaging Molecolare
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
The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2016 Jun 21
Novel treatment of 99Tc-MDP improves clinical and radiographic results for patients with osteochondral lesions of the talus
Hongjuan LIU 1, Huili GUO 1, Shunong GUO 1, Junhui WANG 1, Yanju YE 1, Chao MA 2 ✉
1 Nuclear Medicine of Bone and Joint, Henan Luoyang Zhenggu Hospital and Henan Orthopedics Hospital, Luoyang, China; 2 Nuclear Medicine, Affiliated Xinhua Hospital School of Medicine Shanghai Jiaotong University, Shanghai, China
BACKGROUND: Management of osteochondral lesions of talus (OLT) remains controversial. 99Tc-MDP,a decay product of 99mTc-MDP which is widely used for bone scan, is effective in the clinical treatment of rheumatoid arthritis. The purpose of the study is to investigate the effects of 99Tc-MDP treatment on OLT.
METHODS: In the clinical evaluation, 66 patients with a total of 83 lesions of OLT who failed appropriate nonoperative treatment and surgery were retrospectively included and treated with intravenous injection of 99Tc-MDP and Chinese herbal fumigation (CHF). The effects of 99Tc-MDP and CHF on OLT were evaluated by the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), visual analog scale (VAS), activities of daily living (Barthel index), and MRI, 99mTc-MDP SPECT/CT and CT. Radiographic changes were also assessed by the transverse long diameter of the cyst on CT.
RESULTS: At the last follow up, AOFAS, VAS and Barthel index improved significantly from 68.66±9.76, 3.05±0.34 and 85±8.31 to 85.4±8.31, 1.85±0.36 and 94.7±4.99 (p<0.01), respectively after one course treatment in 66 patients with OLT. Thirty one (31/66) patients had a second treatment course. Their AOFAS, VAS and Barthel index also improved significantly after the mean follow-up of 7 ±2 (6-15) months. And the average diameter of the cysts decreased from 8.01 ± 3.35 mm to 4.74± 2.83mm (p<0.01) in the 31 patients.
CONCLUSIONS: The retrospective study indicates that a combination treatment of 99Tc-MDP and CHF is effective in pain relief and return of function in a short term of follow up for patients with OLT. Our results suggest that the small cystic lesions with increased uptake of 99mTc-MDP on SPECT/CT can be well treated by 99Tc-MDP and CHF. This novel technique holds the potential to emerge as an effective conservative treatment for OLT without adverse effects. The Level of Evidence for 99Tc-MDP is medium for the number of patients and retrospective study.