Immunoscintigraphy of CEA-Producing Tumors with Special Emphasis on the Use of Mab Fragments and ECT
The first reports that carcinoma could be detected in patients by external scanning following injection of purified I-131-labeled anti-CEA antibodies were made by Goldenberg et al. [1, 2]. They claimed that almost all the CEA-producing tumors could be detected by this method and that there were no false-positive results. However, our experience with highly purified goat anti-CEA antibodies  and the same blood pool subtraction technique used by Goldenberg was that only 42% of CEA-producing tumors (22 out of 53 tested) could be detected by this method . Furthermore, we found that in several patients the labeled anti-CEA antibodies localized nonspecifically in the reticuloendothelium, particularly in the liver. Despite the use of the subtraction technique, it was difficult to differentiate this nonspecific uptake from the specific uptake in liver metastases. The discrepancy in the results obtained by the group of Goldenberg and our own is unlikely to be due to a difference in the quality of the anti-CEA antibodies used, since a direct measurement of the radioactivity in tumors resected after injection showed that our antibodies were capable of excellent tumor localization . Furthermore, in a few patients scheduled for tumor resection, we injected simultaneously 1 mg goat anti-CEA antibodies labeled with 1 mCi I-131 and 1 mg control normal goat IgG labeled with 0.2 mCi I-125. With this paired labeled method adapted to the patient situation, we demonstrated that the antibody uptake was four times higher than that of control normal IgG .
KeywordsTumor Uptake Iliac Vessel Intact Antibody Antibody Uptake Cinoembryonic Antigen
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