Radioimmunoscintigraphy with Tc-99m-labelled SM3 in differentiating malignant from benign adnexal masses.
OBJECTIVE
Ultrasound scanning, serum CA125 and menopausal status have previously been combined in a risk of malignancy index for the differential diagnosis of adnexal masses. Although this approach has greater accuracy than either individual tests or clinical assessment, it has a significant false positive and false negative rate. Efforts have been directed at refining differential diagnosis and this study assessed the role of radioimmunoscintigraphy using the stripped mucin 3 (SM3) antibody that has a 17-fold greater uptake in malignant than benign ovarian tumours in vitro.


METHODS
Prospective study of patients with a pelvic mass using radioimmunoscintigraphy.


METHODS
Department of Nuclear Medicine of St Bartholomew's Hospital in collaboration with Cancer Network.


METHODS
A total of 93 patients with pelvic masses were recruited for this study of which 32 had ovarian cancer and 61 had benign lesions.


METHODS
Radioimmunoscintigraphy was performed with Tc-99m-labelled SM3 (600 MBq), anterior and posterior pelvis imaged at 10 minutes and at 4 and 24 hours and evaluated with change detection analysis and probability mapping.


METHODS
Sensitivity and specificity of radioimmunoscintigraphy for ovarian cancer.


RESULTS
Radioimmunoscintigraphy had a sensitivity for ovarian cancer of 84% (27 true positive and 5 false negatives) and a specificity of 87% (53 true negatives and 8 false positives) giving a negative predictive value of 91%.


CONCLUSIONS
These results suggest that radioimmunoscintigraphy could be used to reduce the number of false positive findings in a strategy to refine differential diagnosis of the pelvic mass.
Department of Nuclear Medicine, Bart's and the London, Queen Mary School of Medicine and Dentistry, London University, UK.
N
N
Ali
H
H
Jan
P
P
Van Trappen
F
F
Nasreen
A
A
Canizales
M J
MJ
Carroll
M
M
Granowska
I
I
Jacobs
K E
KE
Britton
D000290:Adnexa Uteri; D000291:Adnexal Diseases / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D018394:CA-125 Antigen / Q000032:analysis; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D055263:Mucin-3; D009077:Mucins / Q000276:immunology*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
D000911:Antibodies, Monoclonal; D018394:CA-125 Antigen; D055263:Mucin-3; D009077:Mucins; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi