Tumor imaging with monoclonal antibodies.
Immunoscintigraphy offers the possibility of specifically targeting human tumors, but the complexity of the human immune system, as well as tumor-related phenomena, prevent monoclonal antibodies from reaching a large number of tumor cells in which they can interact with the antigen. Possible ways to overcome these problems are the use of small fragments, in particular those of genetically engineered humanized antibodies including single immunoglobulin-variable domains, as well as techniques to label the antibody in vivo after a sufficient amount has been taken up by the tumor and the remainder has been eliminated. Despite the low absolute tumor uptake, results of European studies, presently available radiolabeled monoclonal antibodies in gastrointestinal and ovarian cancers yield an average sensitivity of more than 70% with an average specificity of more than 80%, even in otherwise occult tumors. Because of possible tracer uptake in normal liver, the detection rate of liver metastases varies from less than 10% to more than 90%. For the detection of local recurrence in the pelvis, immunoscintigraphy has been found to be more accurate than methods that are based on the imaging of structural changes. Fusion of morphological and functional images might improve the early detection of recurrent and metastatic disease. In melanoma, another tumor that has been extensively studied in Europe, similar results have been obtained, whereas only few data are presently available for other tumors (especially lung and breast cancer).
Bischof Delaloye
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Nuclear Medicine Division, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Delaloye
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B
D000818:Animals; D005060:Europe; D005260:Female; D049673:History, 20th Century; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000000981:diagnostic imaging*; D016719:Radioimmunodetection / Q000266:history / Q000379:methods; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014481:United States