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Cancer Control : Journal of the Moffitt... Nov 1997BACKGROUND: The identification of all sites of intra-abdominal adenocarcinoma is key to optimal surgical resection and tumor staging. Conventional imaging methods and...
BACKGROUND: The identification of all sites of intra-abdominal adenocarcinoma is key to optimal surgical resection and tumor staging. Conventional imaging methods and direct visualization and palpation have limited sensitivity and specificity. Radioimmunoguided surgery (RIGS) has a potential to improve these parameters. METHODS: The development of the RIGS concept is presented, and the studies of tumor localization, detection of disseminated disease, staging, and survival are correlated with the tumor biopsy of gastrointestinal carcinoma, particularly colorectal carcinoma. RESULTS: RIGS can detect clinically and histologically occult neoplasm. Also, by providing immediate intraoperative information, the RIGS approach improves surgical staging, impacts on surgical and medical care, and affects patient prognosis. CONCLUSIONS: RIGS may become the standard of care for the surgical staging and treatment of colorectal cancer and other gastrointestinal malignancies.
PubMed: 10763059
DOI: 10.1177/107327489700400604 -
Journal of Nuclear Medicine : Official... May 1993Preoperative administration of radiolabeled monoclonal antibody allows radioimmunoguided surgery with hand-held intraoperative detection devices. From a theoretical...
Preoperative administration of radiolabeled monoclonal antibody allows radioimmunoguided surgery with hand-held intraoperative detection devices. From a theoretical perspective, this technology may offer more knowledgable patient management and more complete resection of intra-abdominal cancer. False-positive examinations may seriously jeopardize the widespread application of this apparatus. Our experience with a patient with false-positive lymph nodes following administration of 125I-labeled B72.3 monoclonal antibody is reported. After careful histopathological analysis of five nodes thought to be false-positive for cystadenocarcinoma, one lymph node was found to have a minute nidus of cancer. The cause of false-positive radioimmunoguided tests and their implications for the clinical use of this tool is discussed. We interpreted our data to suggest that tumor antigen-monoclonal antibody complexes processed in reactive lymph nodes, anatomically draining the malignant tissue, may cause false-positive tests.
Topics: Adult; Appendiceal Neoplasms; Cystadenocarcinoma; False Positive Reactions; Female; Humans; Lymphatic Metastasis; Radioimmunodetection
PubMed: 8478714
DOI: No ID Found -
Journal of Nuclear Medicine : Official... Jul 1998Pretargeting labeled bivalent hapten with bispecific antibodies has proven feasible in the clinic, and our earlier results have suggested the technique may be very... (Clinical Trial)
Clinical Trial
UNLABELLED
Pretargeting labeled bivalent hapten with bispecific antibodies has proven feasible in the clinic, and our earlier results have suggested the technique may be very sensitive for detecting small recurrences and metastases. Medullary thyroid carcinoma (MTC) is an example where this technique may be the most useful since local recurrences and isolated metastases are removed surgically when detected, and thyrocalcitonin provides a specific and sensitive tumor marker. In our current study, we evaluated pretargeted immunoscintigraphy in a larger number of MTC patients.
METHODS
Anti-carcinoembryonic antigen (CEA) x anti-diethylenetriaminepentaacetic acid (DTPA) indium bispecific antibody and 111In-labeled bivalent DTPA hapten were administered sequentially (4-5 days apart) to 44 patients with elevated circulating calcitonin after resection of primary MTC. Immunoscintigraphy was performed 2, 5 and 24 hr after hapten injection and, when necessary, at longer time intervals. When available, a handheld gamma probe was used during surgery.
RESULTS
Fifteen patients had known tumor sites before immunoscintigraphy. Tumors were imaged in 12 (80%) of these patients, including 3 with liver metastases. Five unknown tumor sites were detected. For the 29 patients with occult disease, immunoscintigraphy detected high-activity uptake sites in 21 patients (72%), including 5 in the liver. Twelve were confirmed by surgery, 1 by guided morphologic imaging and 1 by venous catheterization. There were 2 false-positive patients. The other 5 patients have not yet been confirmed. All detected liver metastases were high-activity uptake areas. Radioimmunoguided surgery was used in 14 patients. It was considered helpful by the surgeon in 12 patients, including 4 patients where it determined the resection of small, not palpable nor visible, tumor-involved lymph nodes. Surgical resection resulted in a significant decrease (8 patients) or normalization (1 patient) of circulating calcitonin and CEA.
CONCLUSION
This technique affords high sensitivity and specificity for detecting small tumor lesions including liver metastases. Its use for immunoscintigraphy and guided surgery should improve the therapeutic management of recurrent MTC.
Topics: Adult; Aged; Antibodies, Bispecific; Biomarkers, Tumor; Carcinoembryonic Antigen; Carcinoma, Medullary; Female; Haptens; Humans; Indium Radioisotopes; Intraoperative Care; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Pentetic Acid; Radioimmunodetection; Radionuclide Imaging; Sensitivity and Specificity; Thyroid Neoplasms
PubMed: 9669389
DOI: No ID Found -
Neurosurgery Jul 2005Scintigraphy with a radiolabeled somatostatin analog ((111)In-diethylenetriaminepenta-acetic acid octreotide) detects the somatostatin receptors that are found in vitro... (Clinical Trial)
Clinical Trial
OBJECTIVE
Scintigraphy with a radiolabeled somatostatin analog ((111)In-diethylenetriaminepenta-acetic acid octreotide) detects the somatostatin receptors that are found in vitro in all meningiomas. Previous studies have proved the benefit of radioimmunoguided surgery, with a hand-held gamma probe, for the assessment and removal of neuroendocrine tumors. We conducted a study to determine whether intraoperative radiodetection of somatostatin receptors is feasible and could increase the probability of complete meningioma resection, especially for bone-invasive en plaque meningiomas, which are difficult to control surgically.
METHODS
Eighteen patients with en plaque sphenoid wing and cranial convexity meningiomas were studied by preoperative and postoperative somatostatin receptor scintigraphy. In 10 of them, intraoperative radiodetection with a hand-held gamma probe was performed 24 hours after the intravenous administration of (111)In-diethylenetriaminepenta-acetic acid octreotide. This procedure was combined with a computer-aided navigation system.
RESULTS
All preoperative scintigrams were positive. Intraoperative gamma probe detection was achieved for the invaded bone, dura, and periorbit of sphenoid wing meningiomas. The average tumor/nontumor count ratio was 2:1, with a maximum of 12:1, thus allowing precise detection capable of defining the tumor margins. In three cases of sphenoid wing meningiomas, postoperative scintigrams were helpful for the determination of recurrences that magnetic resonance imaging failed to detect.
CONCLUSION
These preliminary data show that intraoperative radiodetection of somatostatin receptors with a hand-held gamma probe is feasible and may be helpful to guide the surgical removal of bone-invasive en plaque meningiomas. Preoperative and postoperative scintigraphy may be useful for the management and follow-up of patients with these tumors.
Topics: Adult; Female; Follow-Up Studies; Humans; Intraoperative Care; Male; Meningioma; Middle Aged; Neoplasm Invasiveness; Octreotide; Postoperative Care; Prognosis; Radionuclide Imaging; Radiopharmaceuticals; Receptors, Somatostatin; Skull Neoplasms; Surgery, Computer-Assisted; Treatment Outcome
PubMed: 15987576
DOI: 10.1227/01.neu.0000163490.15578.ff -
Journal of Nuclear Medicine : Official... Aug 1993Two-step radioimmunotargeting using a bispecific anti-CEA/anti-in-DTPA monoclonal antibody and an 111In-labeled DTPA dimer (diDTPA-TL) was evaluated nine times in eight...
Two-step radioimmunotargeting using a bispecific anti-CEA/anti-in-DTPA monoclonal antibody and an 111In-labeled DTPA dimer (diDTPA-TL) was evaluated nine times in eight patients with medullary thyroid cancer (MTC). Immunoscintigraphy was performed 5 and 24 hr after injection of 111In-diDTPA-TL. For five patients, radioimmunoguided surgery (RIGS) was performed using a hand-held gamma probe (sodium iodine), and a biodistribution study was performed 48 hr (four times) and 24 hr (one time) after injection of 111In-diDTPA-TL. Mean tumor uptake (%ID/kg in tumor) was 39 (range 2.75-139). In these five patients, immunoscintigraphy visualized all known tumors and detected unknown foci (US and CT were negative) in the neck (once) and neck and liver (once). Immunoscintigraphy, performed four times in search of a recurrence, detected unknown localizations in the mediastinum and neck (twice) and was negative twice. There were no false-positives. In three of five patients who had surgery, RIGS localized tumor foci not detected by the surgeon. RIGS failed to detect two small lesions (10 x 10 mm) corresponding to sites of fibrosis and microscopic cancer infiltration. Bispecific anti-CEA/anti-In-DTPA mediated targeting of 111In-diDTPA-TL provided elevated tumor uptake and tumor-to-normal tissue ratios. Radioimmunodetection of small MTC lesions is thus possible even when morphological imaging techniques prove negative.
Topics: Carcinoma; Female; Humans; Indium Radioisotopes; Male; Middle Aged; Radioimmunodetection; Thyroid Neoplasms
PubMed: 8326383
DOI: No ID Found -
Zhongguo Fei Ai Za Zhi = Chinese... Feb 2000To determine the sensitivity , specificity and reliability of radioimmunoguided surgery in detecting the tumor micrometastases of the mice models bearing pulmonary...
BACKGROUND
To determine the sensitivity , specificity and reliability of radioimmunoguided surgery in detecting the tumor micrometastases of the mice models bearing pulmonary adenocarcinoma.
METHODS
Radioimmunoguided surgery was performed on mice models bearing pulmonary adenocarcinoma with antihuman lung adenocarcinoma monoclonal antibody (LC-1) by biotin-avidin pretargeting technique.
RESULTS
The result of gamma-camera radioimmunoimaging and the data of radioactivity biodistribution provided by standard gamma well counts showed : as early as 2 hours after injection , radioactivity had accumulated in tumors of the biotinylated monoclonal antibodies pretargeting mice. The T/ NT ratios of the primary tumors and the metastases in the lung were significantly higher in the biotinylated monoclonal antibodies pretargeting mice than those without undergoing such treatment ( P < 0. 01) . Based on the application of GDP to identify the metastases in the lung ,the sensitivity , specificity and accuracy of RIGSwere 96 % , 98 % and 97 % respectively.
CONCLUSIONS
Biotin-avidin pretargeting techniques could remarkably enhance the radio-active deposition on tumors of the biotinylated LC-1 pretargeting mice. The primary tumors and the micrometastases in the lung could be detected in vivo by GDP.
PubMed: 20937214
DOI: 10.3779/j.issn.1009-3419.2000.01.15 -
Oncology (Williston Park, N.Y.) Jul 1995Antibodies against a variety of tumor-associated antigens have been studied, as well as a number of modifications to the antibodies themselves, including Fab' fragments... (Review)
Review
Antibodies against a variety of tumor-associated antigens have been studied, as well as a number of modifications to the antibodies themselves, including Fab' fragments and chimeric, humanized, and human antibodies. The appropriate use of radioimmunoconjugates in the evaluation of cancer patients has not yet been clearly defined. Only a few studies have assessed their use, primarily through the intravenous route, in initial disease staging. To date, immunolymphoscintigraphy has not proven promising in the staging of cancers. More emphasis has been given to the use of IV radioimmunoconjugates to detect residual and recurrent disease, with generally favorable results. In addition, radioimmunoguided surgery, using small, handheld probes to detect foci of antibody accumulation, appears to be a valuable tool. As better production techniques become available and large clinical trials provide more clearly defined indications for radioimmunoconjugate use, these agents should enter the arena for routine diagnostic use.
Topics: Antibodies, Monoclonal; Antibodies, Neoplasm; Antigens, Neoplasm; Humans; Indium Radioisotopes; Neoplasms; Oligopeptides; Pentetic Acid; Radioimmunodetection
PubMed: 8924373
DOI: No ID Found -
British Journal of Cancer May 1999Proteins control cell function and measurement of their concentration is crucial for understanding their roles in health and disease. However, current methods for their...
Proteins control cell function and measurement of their concentration is crucial for understanding their roles in health and disease. However, current methods for their detection in tissue sections are not quantitative. Radioimmunoluminography (RILG) is a system for direct measurement of quantity and distribution of protein in histological sections. Histological carcinomas were reacted with antigen-saturating concentrations of 125I-antibody to carcinoembryonic antigen (CEA). Antibody distribution and concentration was mapped by phosphor imaging. Radioactivity in each pixel of the digital image was proportional to antigen concentration, calculated from a standard line generated from a nitrocellulose CEA dot-blot assay. RILG gave a linear correlation with standards of known CEA concentration (r = 0.999). Six tumour xenografts with differing CEA concentrations by radioimmunoassay (RIA) were studied by RILG and immunohistochemistry (IHC). RILG gave a linear correlation with CEA by RIA (r = 0.994) but IHC failed to do so (r = 0.42). CEA levels measured by RILG, in cryostat (n = 15) and paraffin (n = 19) sections from colorectal cancer patients showed a range of CEA concentration (38.9-594 ng g(-1) and 22.5-212.5 ng g(-1) respectively). Tumour CEA concentration by RILG was significantly correlated with dose of antibody (% injected radioactivity kg(-1)) localized in tumour (P = 0.04 and P < 0.02 respectively), in patients receiving radioimmunoguided surgery. Clinical relevance of RILG is illustrated by identifying patients with high tumour CEA, most likely to benefit from antibody targeted therapy. Knowledge of the pathophysiology of many diseases may be enhanced by quantitative estimation of antigen concentration related to tissue morphology.
Topics: Adenocarcinoma; Animals; Antibodies, Neoplasm; Carcinoembryonic Antigen; Colorectal Neoplasms; Female; Humans; Immunoconjugates; Immunohistochemistry; Iodine Radioisotopes; Radioimmunodetection; Rats; Transplantation, Heterologous
PubMed: 10360677
DOI: 10.1038/sj.bjc.6690443