Clinical experience of the radioimmunoscintigraphy with the 123-I-anti-CEA-Fab(No. 35)-fragment

Purified monoclonal murine 123-I-Fab-anti-CEA(Nr.35) were applied to 7 patients in a prospective study. Compared with the previous tested intact 131-I-labelled antibody (Nr. 202) the new preparation had many advantages for imaging: 2.7 times more counting efficiency of the gamma camera, higher activity utilizable and better accumulation in the tumor with sufficient image contrast in the ECT. Fifteen until sixteen hours after administration of 20 mCi 123-I the countrate in the pelvis was 130000/20 sec. In all patients the primary tumor was visualized, two patients demonstrated regional lymph node involvement and one patient liver metastasis in the left lobe. All findings were confirmed by surgery and histopathology. The average tumor/mucosa ratio was 3.5:1. The activity in the tumor 15 h after application was 0.015 per cent/g tumor/mCi 123-I used. 4/7 patients with colorectal cancer over 3.5 cm in diameter demonstrated normal plasma values of CEA < 3 microg/l. One patient with rising CEA plasma level was suspected of relapse, the focal accumulation corresponded with a mass lesion in the right sacrum in CT-scan. After the preliminary results the further applicability is recognizable: staging and screening before and after therapy, handicapped by high costs at time. A good advantage is the possibility of specific and organ independent diagnosis of tumor, which contents the corresponding surface antigen. (author)