title: Technetium-99m monoclonal antibody fragment (Fab) scintigraphy in the evaluation of small cell lung cancer: a preliminary report.
abstract: Small cell lung cancer (SCC) has the most rapid growth rate of the four cell types and metastasizes early. Present imaging modalities for staging include chest x-ray, CT, MRI and bone scans. In this preliminary study, we assessed the clinical role of 99mTc-monoclonal antibody (MOAB) scintigraphy in five patients with histologically proven SCC. Each patient was infused with 20-30 mCi of 99mTc labeled Fab fragment of MOAB (NR-LU-10, NeoRx, Seattle, Wash.). Total body simultaneous anterior and posterior images were obtained 14-16 h post injection. SPECT images of the chest were obtained through a 360 degrees rotation of the gamma camera and recorded on a 62 x 64 x 16 matrix. Images (1.2 cm thick) were generated in transaxial, sagittal and coronal views. Fourteen of fifteen chest lesions detected by CT were confirmed by 99mTc MOAB scintigraphy. Scintigraphy detected one additional chest lesion not seen by CT. Scintigraphy failed to detect a brain lesion (2 cm), a chest lesion, and two adrenal lesions, all of which were seen by CT. In one patient with multiple (more than 10) lesions in the liver, both scintigraphy and CT detected all lesions. Three spine lesions seen on 99mTc MDP scan and positive for metastasis on MRI concentrated 99mTc MOAB, but two rib lesions seen on 99mTc MDP bone scan did not concentrate 99mTc MOAB. It is concluded from these preliminary results that the potential usefulness of 99mTc MOAB scintigraphy as a complementary imaging modality in the staging of small cell lung cancer should be investigated further.
authors.affiliation: Pulmonary Disease Section, Veterans Administration Medical Center, Portland, OR 97207.
authors.forename: J F
authors.initials: JF
authors.lastname: Morris
authors.forename: S
authors.initials: S
authors.lastname: Krishnamurthy
authors.forename: R
authors.initials: R
authors.lastname: Antonovic
authors.forename: C
authors.initials: C
authors.lastname: Duncan
authors.forename: F E
authors.initials: FE
authors.lastname: Turner
authors.forename: G T
authors.initials: GT
authors.lastname: Krishnamurthy
mesh_terms: D001853:Bone Marrow / Q000000981:diagnostic imaging; D001842:Bone and Bones / Q000000981:diagnostic imaging; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging*; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D016719:Radioimmunodetection; D013667:Technetium
chemical_list: D007140:Immunoglobulin Fab Fragments; D013667:Technetium