NUCLEAR THERAPY PROCEDURES

NUCLEAR THERAPY PROCEDURES

CAT terapia01

RADIOISOTOPE SYNOVIORTESIS

ENDOCAVITARY RADIOISOTOPE TREATMENT

DESCRIPTION

Treatment of synovitis due to chronic inflammatory arthropathies.

PREPARATION

Treatment is done in accordance with the doctor who indicates it (rheumatologist, traumatologist, systemic illnesses specialist, etc.) and once he/she has established that there are no local contraindications (backed-up with X-rays, IRM or TC if necessary).

INDICATIONS

Treatment of synovitis due to chronic inflammatory arthropathies:

  • Rheumatoid arthritis and other arthropathies resistant to medical treatment, such as seronegative arthropathy, hemophilia, villonodular synovitis.
  • Possibility of treating chronic degenerative arthropathy.

DURATION
OF SESSION

30 minutes.

RADIOISOTOPE SYNOVIORTESIS

ENDOCAVITARY RADIOISOTOPE TREATMENT

DESCRIPTION

Treatment of synovitis due to chronic inflammatory arthropathies.

PREPARATION

Treatment is done in accordance with the doctor who indicates it (rheumatologist, traumatologist, systemic illnesses specialist, etc.) and once he/she has established that there are no local contraindications (backed-up with X-rays, IRM or TC if necessary).

INDICATIONS

Treatment of synovitis due to chronic inflammatory arthropathies:

  • Rheumatoid arthritis and other arthropathies resistant to medical treatment, such as seronegative arthropathy, hemophilia, villonodular synovitis.
  • Possibility of treating chronic degenerative arthropathy.

DURATION OF SESSION

30 minutes.

CAT terapia02

RADIOISOTOPE TREATMENT OF HYPERTHYROIDISM

DESCRIPTION

Treatment of hyperthyroidism with I-131.

PREPARATION

  • If the patient’s clinic allows it, the antithyroid treatment must be withdrawn 7 days before the treatment. In severe hyperthyroidism or in cases of cardiological involvement, it is not necessary to remove the antithyroid treatment. The β-blockers are maintained (on demand).
  • A thyroid blood analysis (total T4 and T3, free T4, TSH and antithyroid antibodies) must be performed as well as routine blood count checks before administering the dose.
  • A pregnancy test must be performed to fertile-age women, which must be negative.
  • Therapeutic efficacy control by means of a body rheumatism and SPECT / CT must be checked on the fifth day.
    Patients who do not reach euthyroidism without antithyroid treatment at 3 months will be assessed to receive a new dose of I-131 with the same protocol.
  • In the case of recurrence of disease, the same protocol is followed.

INDICATIONS

  • Treatment of Basedow disease (diffuse goiter).
  • Treatment of multinodular goiter.
  • Treatment of toxic adenoma.

DURATION
OF SESSION

1 hour.

RADIOISOTOPE TREATMENT OF HYPERTHYROIDISM

DESCRIPTION

Treatment of hyperthyroidism with I-131.

PREPARATION

  • If the patient’s clinic allows it, the antithyroid treatment must be withdrawn 7 days before the treatment. In severe hyperthyroidism or in cases of cardiological involvement, it is not necessary to remove the antithyroid treatment. The β-blockers are maintained (on demand).
  • A thyroid blood analysis (total T4 and T3, free T4, TSH and antithyroid antibodies) must be performed as well as routine blood count checks before administering the dose.
  • A pregnancy test must be performed to fertile-age women, which must be negative.
  • Therapeutic efficacy control by means of a body rheumatism and SPECT / CT must be checked on the fifth day.
    Patients who do not reach euthyroidism without antithyroid treatment at 3 months will be assessed to receive a new dose of I-131 with the same protocol.
  • In the case of recurrence of disease, the same protocol is followed.

INDICATIONS

  • Treatment of Basedow disease (diffuse goiter).
  • Treatment of multinodular goiter.
  • Treatment of toxic adenoma.

DURATION OF SESSION

1 hour.

CAT terapia03

RADIOISOTOPE TREATMENT OF DIFFERENTIATED LOW-RISC
THYROID CANCER (REMNANTS ABLATION)

DESCRIPTION

Treatment of differentiated low-risk thyroid cancer with I-131.

PREPARATION

  • The antithyroid treatment must be withdrawn 4 weeks before the treatment or else, rhTSH stimulation must be done.
  • A thyroid blood analysis (with basal and stimulated thyroglobulin measurements) and a regular blood count must be performed before administering the dose.
  • A pregnancy test must also be done to fertile-age women, which must be negative.
  • A control of therapeutic efficacy by whole-body scan and SPECT/CT must be performed on the fifth day after the treatment.
  • Patients who do not achieve ablation can repeat the treatment 6 months later under the same protocol.
  • In case of recurrence, the same protocol is followed.

INDICATIONS

Treatment of differentiated low-risk thyroid cancer.

DURATION
OF SESSION

1 hour.

RADIOISOTOPE  TREATMENT OF
DIFFERENTIATED LOW-RISC
THYROID CANCER (REMNANTS ABLATION)

DESCRIPTION

Treatment of differentiated low-risk thyroid cancer with I-131.

PREPARATION

  • The antithyroid treatment must be withdrawn 4 weeks before the treatment or else, rhTSH stimulation must be done.
  • A thyroid blood analysis (with basal and stimulated thyroglobulin measurements) and a regular blood count must be performed before administering the dose.
  • A pregnancy test must also be done to fertile-age women, which must be negative.
  • A control of therapeutic efficacy by whole-body scan and SPECT/CT must be performed on the fifth day after the treatment.
  • Patients who do not achieve ablation can repeat the treatment 6 months later under the same protocol.
  • In case of recurrence, the same protocol is followed.

INDICATIONS

Treatment of differentiated low-risk thyroid cancer.

DURATION OF SESSION

1 hour.

CAT terapia04

RADIOISOTOPE TREATMENT OF METASTATIC BONE PAIN WITH STRONTIUM-89 (METASTRON), SAMARIUM-153 (QUADRAMET) AND RADIUM-223 (XOFIGO)

DESCRIPTION

Treatment of pain produced by bone metastasis of prostate or breast carcinoma, resistant to hormone therapy, chemotherapy or analgesics.

PREPARATION

No previous preparation is needed.

INDICATIONS

Treatment of bone pain produced by bone metastases of prostate or breast cancer resistant to chemo and hormone therapy or to analgesics. To receive treatment the patient must:

  • Presence of pain caused by bone metastases, coinciding the location of the pain with images compatible with metastasis in a bone scintigraphy. The Karnofsky Index must be 60 or higher. Patients with lower numbers may receive treatment, although in these cases the response is not so favorable.
  • Presence of pain despite regular treatment with opioid or non-opioid analgesics.
  • Patient’s must have preservation of his/her renal function and a hematological function with platelets counts greater than 100 x 109/L and leukocytes counts greater than 3 x 109/L.

DURATION
OF SESSION

16 minutes.

RADIOISOTOPE TREATMENT OF METASTATIC BONE PAIN
WITH STRONTIUM-89 (METASTRON), SAMARIUM-153
(QUADRAMET) AND RADIUM-223 (XOFIGO)

DESCRIPTION

Treatment of pain produced by bone metastasis of prostate or breast carcinoma, resistant to hormone therapy, chemotherapy or analgesics.

PREPARATION

No previous preparation is needed.

INDICATIONS

Treatment of bone pain produced by bone metastases of prostate or breast cancer resistant to chemo and hormone therapy or to analgesics. To receive treatment the patient must:

  • Presence of pain caused by bone metastases, coinciding the location of the pain with images compatible with metastasis in a bone scintigraphy. The Karnofsky Index must be 60 or higher. Patients with lower numbers may receive treatment, although in these cases the response is not so favorable.
  • Presence of pain despite regular treatment with opioid or non-opioid analgesics.
  • Patient’s must have preservation of his/her renal function and a hematological function with platelets counts greater than 100 x 109/L and leukocytes counts greater than 3 x 109/L.

DURATION OF SESSION

15 minutes.

CAT terapia05

RADIOISOTOPE TREATMENT OF POLYCYTHEMIA VERA
AND ESSENTIAL THROMBOCYTHEMIA

DESCRIPTION

Treatment of polycythemia vera and essential thrombocytosis with P-32 in the form of sodium phosphate.

PREPARATION

  • No preparation required.
  • childbearing-age women, with the possibility of being pregnant, should not be subjected to this treatment.

INDICATIONS

  • Erythrocytosis not controlled by phlebotomies.
  • Excessive thrombocytosis, with platelet counts over 800,000 per mm3.
  • Extramedullary hematopoiesis with splenic pain, hypersplenicity, abdominal pain or splenic infarction.
  • Cardiovascular pathology in which repeated phlebotomies are contraindicated.
  • Persistent symptoms, such as pruritus or hyperuricemia not controlled by phlebotomy, antihistamines or allopurinol.

DURATION
OF SESSION

 15 minutes.

RADIOISOTOPE TREATMENT OF POLYCYTHEMIA
VERA AND ESSENTIAL THROMBOCYTHEMIA

DESCRIPTION

Treatment of polycythemia vera and essential thrombocytosis with P-32 in the form of sodium phosphate.

PREPARATION

  • No preparation required.
  • childbearing-age women, with the possibility of being pregnant, should not be subjected to this treatment.

INDICATIONS

  • Erythrocytosis not controlled by phlebotomies.
  • Excessive thrombocytosis, with platelet counts over 800,000 per mm3.
  • Extramedullary hematopoiesis with splenic pain, hypersplenicity, abdominal pain or splenic infarction.
  • Cardiovascular pathology in which repeated phlebotomies are contraindicated.
  • Persistent symptoms, such as pruritus or hyperuricemia not controlled by phlebotomy, antihistamines or allopurinol.

DURATION OF SESSION

15 minutes.

CAT terapia06

LYMPHOMA TREATMENT WITH ZEVALIN

DESCRIPTION

Treatment and induction to remission of follicular non-Hodgkin’s lymphoma of B CD20 + cells in relapse or refractories to treatment with Rituximab. Zevalin combines the targeted capability of an anti CD20 monoclonal antibody with the cytotoxic potential of yttrium-90 to destroy tumor cells (Ibritumomab, Tiuxetan).

PREPARATION

  • No special preparation needed.
  • In patients with very low platelet counts, the dose should be reduced.

INDICATIONS

Follicular no-Hodgkin lymphoma of B CD20 + cells in relapse or refractory to treatment with Rituximab.

DURATION
OF SESSION

4 hours.

LYMPHOMA TREATMENT WITH ZEVALIN

DESCRIPTION

Treatment and induction to remission of follicular non-Hodgkin’s lymphoma of B CD20 + cells in relapse or refractories to treatment with Rituximab. Zevalin combines the targeted capability of an anti CD20 monoclonal antibody with the cytotoxic potential of yttrium-90 to destroy tumor cells (Ibritumomab, Tiuxetan).

PREPARATION

  • No special preparation needed.
  • In patients with very low platelet counts, the dose should be reduced.

INDICATIONS

Follicular no-Hodgkin lymphoma of B CD20 + cells in relapse or refractory to treatment with Rituximab.

DURATION OF SESSION

4 hours.

CAT gastro07

131I-MIBG THERAPY

DESCRIPTION

.

PREPARATION

.

INDICATIONS

.

DURATION
OF SESSION

.

131I-MIBG THERAPY

DESCRIPTION

.

PREPARATION

.

INDICATIONS

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DURATION OF SESSION

.

CAT terapia09

SPECIALIST’S HOME VISIT

DESCRIPTION

Medical home visit by a Nuclear Medicine specialist.

PREPARATION

Previous medical reports and medication, if any,  must be handy.

INDICATIONS

  • Metabolic therapy.
  • Hyperthyroidism.
  • Bone pain treatment.
  • Sinoviortesis.
  • Other specific reasons.

DURATION
OF VISIT

Not determined

SPECIALIST’S HOME VISIT

DESCRIPTION

Medical home visit by a Nuclear Medicine specialist.

PREPARATION

Previous medical reports and medication, if any,  must be handy.

INDICATIONS

  • Metabolic therapy.
  • Hyperthyroidism.
  • Bone pain treatment.
  • Sinoviortesis.
  • Other specific reasons.

DURATION OF VISIT

Not determined

CAT terapia08

SPECIALIST’S EMERGENCY HOME VISIT

DESCRIPTION

Emergency medical home visit by a Nuclear Medicine specialist.

PREPARATION

Previous medical reports and medication, if any,  must be handy.

INDICATIONS

  • Metabolic therapy.
  • Hyperthyroidism.
  • Bone pain treatment.
  • Sinoviortesis.
  • Other specific reasons.

DURATION
OF VISIT

Not determined

SPECIALIST’S EMERGENCY HOME VISIT

DESCRIPTION

Emergency medical home visit by a Nuclear Medicine specialist.

PREPARATION

Previous medical reports and medication, if any,  must be handy.

INDICATIONS

  • Metabolic therapy.
  • Hyperthyroidism.
  • Bone pain treatment.
  • Sinoviortesis.
  • Other specific reasons.

DURATION OF VISIT

Not determined

.

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Josep Irla & Bosch Street, 5-7, Basement, Barcelona 08034, Catalonia, Spain
(+34) 93 204 6439, (+34) 93 205 7708 Fax (+34) 93 204 8641 info@simm.barcelona

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Logo-SIMM-Largo

Josep Irla & Bosch Street, 5-7, Basement, Barcelona 08034, Catalonia, Spain
Phones (+34) 93 204 6439 & (+34) 93 205 7708 Fax (+34) 93 204 8641
E-mail info@simm.barcelona

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