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Alternative therapies or a multimodal approach is often necessary to ensure complete eradication and prevent recurrence. The use of radioactive creams or patches embedded with Holmium-166, Phosphorus-32 for superficial skin lesions has been documented to be safe and effective. The use of Rhenium-188 has proved effective in non-melanoma skin cancers. We report on the initial experience with Rhenium-188 SCT in the treatment of recurrent keloid lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with recurrent keloid lesions were recruited for therapy with Rhenium-188. These patients had failed most forms of therapy including surgery, intralesional steroids and radiation therapy. Treatment with\n                      <jats:sup>188<\/jats:sup>\n                      Re via a specialized unit (Rhenium SCT -Oncobeta) was applied onto the keloid lesion. A personalized treatment time was calculated for every patient. Topical\n                      <jats:sup>188<\/jats:sup>\n                      Rhenium delivered as a jelly like matrix containing an insoluble dirhenium-heptasulfide was applied to every target lesion in a single session. The goal is to deliver 30\u00a0Gy to the deepest part of the lesion per session (3\u00a0mm). Patients were followed up at 2 weeks, 1, 3, 6 and 12 months for side effects as well as clinical and cosmetic outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 58 lesions were treated. Majority of the lesions were in the head and neck region. The smallest area for treatment was 0.25cm\n                      <jats:sup>2<\/jats:sup>\n                      and the largest area treated was 46.25cm\n                      <jats:sup>2<\/jats:sup>\n                      . With the exception of four patients (2 sessions to the same lesion), all the other patients received a single session of therapy. The mean activity administered was 256,7MBq (range: 35MBq\u2013 663,50MBq). The treatment time averaged 350.89\u00a0min (range: 85\u20131304\u00a0min). There was complete response in 72% of the lesions. Hypopigmentation was the commonest expected long term side effect. After a median follow-up period of 37 months (range: 7\u201353), there was a 7% recurrence rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Treatment with\n                      <jats:sup>188<\/jats:sup>\n                      Re is a great alternative in patients with keloids that have had minimal success with other therapies. The use of the specialized applicator system provides great flexibility, reduced morbidity and great results that are comparable to other therapies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07184-4","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T23:13:44Z","timestamp":1741734824000},"page":"3151-3158","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Alternative treatment for recurrent keloids: initial clinical experience with Rhenium-188 using a specialized device"],"prefix":"10.1007","volume":"52","author":[{"given":"Kgomotso M. 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Written informed consent was obtained from the patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors consent to publish and print the data contained in this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Mokoala KMG: nothing to disclose, Nonjola L: nothing to disclose, Moeng T: nothing to disclose, Corbett C: nothing to disclose, Magwaza M: Holds shares in Oncobeta, Dahlhoff G: Holds shares in Oncobeta, Brown S: Holds shares in Oncobeta, Vorster M: nothing to disclose, Sathekge MM: Associate Editor of EJNMMI.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}