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99mTc-Interleukin-2 Scintigraphy as a Potential Tool for Evaluating Tumor-Infiltrating Lymphocytes in Melanoma Lesions: A Validation Study

Alberto Signore, MD1, Alessio Annovazzi, MD1, Raffaella Barone, MD1, Elena Bonanno, MD2, Calogero D’Alessandria, BSc1, Marco Chianelli, MD, PhD3, Stephen J. Mather, PhD4, Ugo Bottoni, MD5, Chiara Panetta, MD5, Daniele Innocenzi, MD5, Francesco Scopinaro, MD1 and Stefano Calvieri, MD5

1 Nuclear Medicine Unit, Departments of Clinical Sciences and Radiological Sciences, Second Faculty of Medicine, University "La Sapienza," Rome, Italy
2 Department of Biopathology and Diagnostic Imaging, University "Tor Vergata," Rome, Italy
3 Nuclear Medicine Unit, "Regina Apostolorum" Hospital, Albano Laziale, Rome, Italy
4 Department of Nuclear Medicine, St. Bartholomew’s Hospital, Cancer Research U.K., London, United Kingdom
5 Department of Dermatology and Plastic Surgery, University "La Sapienza," Rome, Italy



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  		FIGURE 1. 99mTc-IL2 scintigraphy (A) of a patient with a large melanoma (arrow) of the left gluteus (B). Despite the large size of the tumor, the distribution of radioactivity is inhomogeneous, reflecting patchy infiltration by activated T lymphocytes. T/B ratio was 1.81. (C) CD25 staining showed a mild positivity for neoplastic cells and a strong diffuse positivity for lymphocytes.

 


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  		FIGURE 2. 99mTc-IL2 scintigraphy (A) of a patient with a small melanoma near the right clavicle (B). Despite the small size of the tumor (green arrow), regional lymph nodes are also detectable (red arrow), reflecting active immune response inside primary and metastatic tumors. T/B ratio was 1.44. (C) CD25 staining showed a mild positivity for neoplastic cells and a strong diffuse positivity for lymphocytes.

 


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  		FIGURE 3. 99mTc-IL2 scintigraphy of a patient with a melanoma of the right foot. Moderate 99mTc-IL2 uptake (T/B = 1.14) is detectable in the tumor area (arrow).

 


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  		FIGURE 4. 99mTc-IL2 scintigraphy of a patient with a melanoma of the left foot. Strong 99mTc-IL2 uptake (T/B = 1.48) is detectable in the tumor area (arrow).

 


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  		FIGURE 5. 99mTc-IL2 scintigraphy of a patient with a melanoma of the left arm. No significant 99mTc-IL2 uptake (T/B = 1.00) is detectable in the tumor area (arrow).

 


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  		FIGURE 6. 99mTc-IL2 scintigraphy of a patient with an angioma of the left thigh. No significant 99mTc-IL2 uptake (T/B = 1.00) is detectable in the tumor area (arrow).

 


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  		FIGURE 7. Correlation between T/B ratios at 99mTc-IL2 scintigraphy and the percentage of CD25-positive TILs (A) and melanoma cells (B).

 




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