Multi-centre immunoscintigraphic study using indium-111-labelled CEA-specific and/or 19-9 monoclonal antibody F(ab')2 fragments.
Six European nuclear medicine centres performed immunoscintigraphy first retrospectively in 34 patients using indium-111-labelled carcinoembryonic antigen (CEA)-specific and/or 19-9 F(ab')2 fragments. Results for sensitivity and specificity in tumour sites were 94% and 87%, respectively, for the pelvis and 73% and 100% for the extrahepatic abdomen. A second prospective series concerned 58 other patients previously operated on for colorectal adenocarcinoma (27 colon, 31 rectum). Two-thirds of these patients had a suspected recurrence signalled by an isolated rise in tumour markers, and 46 patients examined by immunoscintigraphy, X-ray computed tomography and ultrasonography were found to have a recurrence (a total of 62 tumour sites). Sensitivity and specificity with immunoscintigraphy were 90% and 97%, respectively, for the pelvis and 62% and 95% for the extrahepatic abdomen. For 29 patients injected with CEA-specific fragments, sensitivity was 90% and specificity 94% for the pelvis. For 25 patients injected with 19-9 fragments, pelvic sensitivity and specificity were 80% and 100%, respectively, whereas sensitivity for the extrahepatic abdomen was only 29% since several cases of peritoneal carcinosis were not visualized. In the prospective series, comparison of the three imaging techniques for all tumour sites (including liver and in 5 cases thorax) gave a sensitivity and specificity of 82% and 91%, respectively, for immunoscintigraphy, 52% and 95% for X-ray computed tomography and 59% and 100% for ultrasonography. These results thus confirm the advantage of using 111In-labelled CEA-specific or 19-9 to visualize and localize recurrences of colorectal cancer.
Chetanneau
A
A
Centre René Gauducheau, Nantes, France.
Baum
R P
RP
Lehur
P A
PA
Liehn
J C
JC
Perkins
A C
AC
Bares
R
R
Bourguet
P
P
Herry
J Y
JY
Saccavini
J C
JC
Chatal
J F
JF
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000911:Antibodies, Monoclonal; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000276:immunology*; D002272:Carcinoembryonic Antigen / Q000276:immunology*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000276:immunology*; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
D000911:Antibodies, Monoclonal; D015295:Antigens, Tumor-Associated, Carbohydrate; D002272:Carcinoembryonic Antigen; D007140:Immunoglobulin Fab Fragments; D007205:Indium Radioisotopes