Detection of occult tumor using indium 111-labeled anticarcinoembryonic antigen antibodies

S. E. Halpern, R. O. Dillman, D. Amox, P. L. Hagan, R. Burks, J. Dillman, B. Perdikakis, B. Merchant, J. Frincke and S. Schweighardt
Department of Nuclear Medicine, Veterans Affairs Medical Center, San Diego, CA 92161.

Even with the advancement of radiologic techniques, metastatic cancers can still be difficult to detect. In this study, 48 patients suspected of having occult metastases were studied by radioimmunodetection following the administration of 92.5 to 181.3 MBq of indium 111-labeled monoclonal anticarcinoembryonic antigen antibody. All but seven patients were thought to have metastatic colorectal carcinoma. In the majority of cases, physical examinations and computed tomographic scans had failed to detect a lesion. At least one lesion that was later proved to exist was detected in 34 of the 50 studies performed on these patients. Seven of eight patients with normal radioimmunodetection scans remain free of disease. One hundred one sites were detected overall; 60 were considered true-positive sites and 27 false-positive sites. Fourteen sites remained in question. Nineteen false-negative sites occurred. Radioimmunoimaging appears valuable for the detection of occult cancer where standard, noninterventional techniques have failed to detect the suspected disease.