title: 123I-N-(2-diethylaminoethyl)-2-iodobenzamide: a potential imaging agent for cutaneous melanoma staging.
abstract: Melanoma is a neoplasia of dramatically increasing incidence that has a propensity to spread rapidly. Early detection is fundamental and patient management requires reliable, sensitive and reproducible staging methods, such as a single examination by planar scintigraphy or single-photon emission tomography (SPET) using a radiopharmaceutical with selectivity for melanoma tissue. Among iodobenzamides reported to possess an affinity for melanoma, a new compound, N-(2-diethylaminoethyl)-2-iodobenzamide (BZA(2)), was selected for a clinical trial in view of its pharmacokinetic experimental profile in melanoma-bearing mice. Planar whole-body scintigraphy using (123)I-BZA(2) was performed in 25 patients with histologically proven cutaneous melanoma. Performance was evaluated in two groups of patients with one or more documented secondary lesions ( n=13) or with no known secondary lesions ( n=12), and results were compared with those of conventional investigation techniques. No adverse clinical or biological events were recorded. Lesions were imaged by increased tracer uptake, and good quality images were obtained 4 h after administration. After a follow-up of more than 1 year, the overall results of (123)I-BZA(2) scintigraphy on a per patient basis showed a sensitivity of 100%, a specificity of 95%, a positive predictive value of 86% and a negative predictive value of 100%. The proven secondary lesions were imaged with a sensitivity of 100% and a specificity of 91%. In seven patients with suspected metastases, the absence of (123)I-BZA(2) uptake was confirmed as true negative, and in one patient without suspected metastases, (123)I-BZA(2) scintigraphy revealed a gastric lesion. Hence eight diagnoses would have been modified by (123)I-BZA(2) scintigraphy data. (123)I-BZA(2) allowed discrimination between benign and malignant lesions and, in the case of malignancies, between those of melanomatous origin and others. This compound, which is selective for melanoma tissue, appears promising for the staging and restaging of melanoma.
authors.affiliation: UMR 484 INSERM-Université d'Auvergne, Centre Jean Perrin, Rue Montalembert, BP 184, 63005 Clermont-Ferrand, France. moins@inserm484.u-clermont1.fr
authors.forename: Nicole
authors.initials: N
authors.lastname: Moins
authors.forename: Michel
authors.initials: M
authors.lastname: D'Incan
authors.forename: Jacques
authors.initials: J
authors.lastname: Bonafous
authors.forename: Franck
authors.initials: F
authors.lastname: Bacin
authors.forename: Pierre
authors.initials: P
authors.lastname: Labarre
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Moreau
authors.forename: Danièle
authors.initials: D
authors.lastname: Mestas
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Noirault
authors.forename: Florence
authors.initials: F
authors.lastname: Chossat
authors.forename: Eric
authors.initials: E
authors.lastname: Berthommier
authors.forename: Janine
authors.initials: J
authors.lastname: Papon
authors.forename: Martine
authors.initials: M
authors.lastname: Bayle
authors.forename: Pierre
authors.initials: P
authors.lastname: Souteyrand
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Madelmont
authors.forename: Annie
authors.initials: A
authors.lastname: Veyre
mesh_terms: D000328:Adult; D000368:Aged; D001549:Benzamides / Q000097:blood / Q000494:pharmacology / Q000652:urine; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000556:secondary*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D001549:Benzamides; C475761:N-(2-(diethylamino)ethyl)-2-iodobenzamide; D019275:Radiopharmaceuticals