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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multiple imaging methods are currently used to detect the presence, location, and extent of breast cancer, either at initial presentation or during follow-up. Even at initial diagnosis, more specific methods are needed to complement the high sensitivity of mammography in the detection and diagnosis of mammary carcinoma. Therefore, the current study evaluates the potential use of a new monoclonal antibody-based imaging agent, arcitumomab (CEA-Scan), which comprises an anti-carcinoembryonic antigen monoclonal antibody Fab' fragment labeled directly with technetium-99m, in the detection of primary, recurrent, or metastatic mammary cancer. A prospective, non-randomized, open-label, multicenter trial was conducted in 123 women 100 with primary breast cancer confirmed by histology or cytology, and 23 with a prior history and who were under evaluation for possible recurrence or metastasis. A 1-mg dose of arcitumomab labeled with 20-25 mCi Tc-99m was injected i.v., and planar images were acquired at 5-8 hr, as well as single-photon emission computed tomography. Additional planar scanning was performed optionally at 18-24 hr. The imaging studies were interpreted as positive if there was abnormal focal activity, and were correlated, wherever possible, with histopathology or conventional imaging tests. In 78 evaluable patients with primary breast carcinoma arcitumomab showed an imaging sensitivity and specificity of 82% and 88%, respectively, even detecting lesions < 1 cm in 61% of the cases. Among 58 patients evaluable for axillary node involvement, 30 were positive by histopathology, of which arcitumomab was correct in 19 with cancer (63% sensitivity) and in 25 of 28 without cancer (89% specificity). Among 88 primary operable patients, arcitumomab showed additional sites of focal uptake outside of the breasts and axillae in 10, or 11%. In a total of 19 breast cancer patients with known or suspected recurrence or metastatic disease, 13, or 68%, showed one or more focal sites of uptake, involving the typical sites of spread of mammary cancer. No significant adverse effects or induction of human antimouse antibodies were observed in these patients. Arcitumomab immunoscintigraphy is a simple, same-day, and safe new imaging modality for the detection of sites of breast cancer, including lesions < 1 cm, with a reasonably high rate of sensitivity and specificity. It may be used to complement mammography in the differentiation of malignant from benign disease.
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PMID:Studies of breast cancer imaging with radiolabeled antibodies to carcinoembryonic antigen. Immunomedics Breast Cancer Study Group. 922 88

Radioimmunoscintigraphy (RIS) is coming into its own as an imaging modality in clinical oncology. Early experience with indium-111-labeled intact murine monoclonal antibodies (MoAbs) in colorectal cancer suggested that RIS images hepatic metastases poorly. Moreover, an antimurine immune response was frequently provoked, precluding multiple follow-up RIS studies in individual patients due to reticuloendothelial sequestration of the radioimmunoconjugate before tumor targeting could occur. Recent trials of technetium-99m-labeled antibody fragments and human MoAbs have demonstrated significant improvement in imaging efficacy, and repeated or serial imaging is possible because of the absence of associated immunogenicity. RIS is demonstrably more sensitive than conventional diagnostic modalities (CDM) such as computed tomography (CT) for detection of extrahepatic abdominal and pelvic colorectal carcinoma and is complementary to CDM in imaging liver metastases. In a surgical decision-making analysis comparing CT, RIS (IMMU-4 99mTc-Fab'; CEA-Scan), and CT plus RIS in patients with recurrent or metastatic colorectal cancer, CT plus RIS improved correct prediction of resectability by 40% and correct prediction of unresectability by 100% compared with CT alone. At the present time, RIS used in combination with CDM contributes an incremental improvement in diagnostic accuracy in colorectal cancer patients with known or suspected recurrent disease. Basic and clinical research currently in progress promises to yield agents and methods that provide rapid high-resolution imaging, high tumor-to-background ratios in all organs at risk for tumor recurrence or metastasis, negligible immunogenicity and toxicity, and a significant further improvement in the accuracy of clinical decision making in oncology patients.
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PMID:A thousand points of light or just dim bulbs? Radiolabeled antibodies and colorectal cancer imaging. 1037 Mar 60

Imaging of cancer by radioimmunoscintigraphy (RIS) following administration of radiolabeled monoclonal antibodies (mAbs) or fragments has been under development for two decades. Efficacy is a function of many variables: antigen expression on tumor cells relative to normal tissues and body fluids, affinity, specificity, pharmacokinetics and immunogenicity of the mAb and properties of the radionuclide and imaging techniques. CEA-Scan (a 99mTclabeled Fab' fragment of a mouse mAb directed against CEA) has several advantageous properties, and has been approved for use in colorectal cancer SPECT imaging in North America and Europe, and is also under investigation in Japan. It has been shown to complement CT in detecting recurrent or metastatic disease, even in the liver where 111In mAbs frequently fail. In breast cancer, it provides clearer identification of malignant disease in patients with indiscriminate mammography. Recently, it has also been used intra-operatively in radio-immunoguided surgery in both colorectal and breast cancer patients. These new applications are currently under active investigation and clinical trials are planned. Clinically useful information is obtained in a relatively high percentage of patients, which can alter treatment decisions. In most cases the benefits are in reducing unnecessary surgery or biopsies in inoperable patients, but major benefits (especially in colorectal cancer) would be obtained if new therapies effective against the RIS-detected minimal residual disease were forthcoming.
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PMID:Technology evaluation: CEA-Scan, Immunomedics Inc. 1962 71