Serafini A N, Kotler J, Feun L, Dewanjee M, Robinson D, Salk D, Sfakianakis G, Abrams P, Savaraj N, Goodwin D
Department of Radiology, University of Miami School of Medicine, Florida.
Clin Nucl Med. 1989 Aug;14(8):580-7. doi: 10.1097/00003072-198908000-00006.
Twenty-six stage II/III malignant melanoma patients with 321 measurable metastatic lesions were imaged using Fab fragments of an IgG murine monoclonal antibody labeled specifically with 10-30 mCi Tc-99m with a bi-functional chelating method (NeoRx, Seattle, WA). There were no side effects or adverse reactions. Immunoscintigraphy demonstrated 66.6% of lesions larger than 1 cm and 92.5% of lesions larger than 3 cm. Most frequently detected metastases were in lymph nodes, subcutaneous areas, and bone. Of lesions less than 1 cm, 23.6% were detected if superficial cutaneous lesions were excluded. The smallest detectable lesion was 4 mm. Twenty-one additional clinically unsuspected sites were visualized in 12 of the 26 patients studied. Of these, 56% were confirmed as metastasis by other tests. There were apparent nonspecific localizations owing to other causes, including fracture, varicosities, skin abscess and pneumonitis. Increased experience in image analysis facilitates correct interpretation of these localizations. This study demonstrates that imaging with Tc-99m labeled antibody fragments detects melanoma lesions in organs routinely surveyed and in other areas not routinely assessed by other imaging techniques. The procedure is readily performed and safe. The principal advantage of the test is its ability to survey the entire body and all organs with a single test. Its principal limitation, in common with other diagnostic imaging procedures, is its poor sensitivity for detecting lesions less than 1 cm.
26例II/III期恶性黑色素瘤患者，共321个可测量的转移病灶，采用双功能螯合法，用10 - 30毫居里的Tc - 99m特异性标记的IgG鼠单克隆抗体的Fab片段进行成像（NeoRx，华盛顿州西雅图）。未出现副作用或不良反应。免疫闪烁显像显示，直径大于1厘米的病灶检出率为66.6%，直径大于3厘米的病灶检出率为92.5%。最常检测到转移的部位是淋巴结、皮下区域和骨骼。对于直径小于1厘米的病灶，若排除浅表皮肤病灶，检出率为23.6%。最小可检测病灶为4毫米。在研究的26例患者中，有12例发现了另外21个临床未怀疑的部位。其中，56%经其他检查确认为转移灶。还存在因其他原因导致的明显非特异性定位，包括骨折、静脉曲张、皮肤脓肿和肺炎。图像分析经验的增加有助于对这些定位进行正确解读。本研究表明，用Tc - 99m标记的抗体片段成像可检测常规检查器官及其他成像技术未常规评估区域的黑色素瘤病灶。该操作简便且安全。该检测的主要优点是一次检测就能对全身和所有器官进行检查。与其他诊断成像程序一样，其主要局限性是对直径小于1厘米的病灶检测灵敏度较低。
