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Anti-Carcinoembryonic Antigen Immunoscintigraphy (Technetium-99m-Monoclonal Antibody BW 431/26) and Serum CEA Levels in Patients with Suspected Primary and Recurrent Colorectal Carcinoma

Internal Department/Nuclear Medicine, Barmherzige Brüder Eggenberg Hospital, Graz, Austria
Department of Surgery, Department of Radiotherapy, and Institute of Pathology, University of Graz, Austria

Correspondence: For reprints contact: Peter Lind, MD, Internal Department/Nuclear Medicine, Barmherzige Brüder Eggenberg Hospital, Bergstrasse 27, A-8020 Graz, Austria.

ABSTRACT

This study comprises a total of 141 patients with suspected primary and recurrent colorectal carcinomas, in whom immunoscintigraphy with ^99mTc-Mab BW 431/26 was performed. Whole-body scans were done 5.5 hr and SPECT imaging of the abdominal region was done at 6 and 24 hr postinjection of 1100 MBq ^99mTc-labeled Mab (1 mg). In the course of primary tumor identification (n = 65), sensitivity of anti-CEA immunoscintigraphy was 95%, specificity 91%. In the diagnosis of early recurrences (n = 76), immunoscintigraphy was the method of choice to clarify the problem (sensitivity 94%; specificity 86%). Overall sensitivity of immunoscintigraphy in patients with suspected colorectal carcinomas and early recurrences was 95%, specificity 88%. Human anti-mouse antibodies were found in 29% (80% predominantly anti-isotypic, 20% predominantly anti-idiotypic). In contrast to anti-CEA immunoscintigraphy, the results of serum CEA levels were rather disappointing. Only 18 out of the 43 surgically verified primary colorectal carcinomas and 17 out of 32 patients with recurrences showed elevated serum CEA levels. In our clinical experience with this ^99mTc-labeled anti-CEA antibody, immunoscintigraphy can play an important role in the identification of early colorectal recurrences and in postoperative colorectal cancer patients it should be performed in cases with unclear transmission computed tomography.

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