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Preoperative Scintigraphy and Operative Probe Scintimetry of Colorectal Carcinoma Using Technetium-99m-88BV59

Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida
Organon Teknika/Biotechnology Research Institute, Rockville, Maryland

Correspondence: For correspondence or reprints contact: Dr. F.L. Moffat, Jr., University of Miami School of Medicine, Sylvester Comprehensive Cancer Center, Surgical Oncology (310T), Room 3550, 3rd Fl., 1475 N.W. 12th Ave., Miami, FL 33136.

ABSTRACT

We report a pilot study of radioimmunoscintigraphy (RIS) and operative gamma probe scintimetry (OPS) using a ^99mTc-labeled anti-cytokeratin human monoclonal antibody (MAb) (^99mTc-88BV59) in patients with newly diagnosed, recurrent or metastatic colorectal cancer. Methods: Twelve presurgical patients with biopsy- or contrast radiographic-proven colorectal cancer or recurrent colorectal carcinoma were studied. After chest roentgenography and abdominopelvic CT, ^99mTc-88BV59 was administered intravenously, planar and SPECT external imaging was performed 3 to 6 hr after injection and planar imaging was performed 18 to 24 hr after injection. Surgery was performed immediately after late planar imaging. OPS of a standardized list of sites to document background radiation activity and of tumor sites, resection margins and tumor beds was performed. Results: The patients had 23 histologically proven tumor sites. Overall sensitivity for CT, planar RIS, SPECT, surgery and OPS was 43%,61%, 78%, 96% and 91%, respectively. SPECT was superior to CT for imaging extrahepatic abdominal and pelvic disease. OPS detected all liver and extrahepatic abdominal tumor sites and correctly predicted histological tumor-free margins and tumor beds in all cases. OPS did not identify tumor deposits that the surgeon could neither see nor feel. No patient demonstrated human anti-human immune responsiveness 1 and 3 mo after ^99mTc-88BV59 infusion. Conclusion: Technetium-99m-88BV59 is a safe, effective radioimmunoconjugate for colorectal cancer imaging, with superior sensitivity as compared to CT.

Key Words: radioimmunoscintigraphy • gamma detection probe • human immunoconjugates • colorectal carcinoma • scintimetry