• 대한핵의학회지
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• 제24권1호
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• pp.29-36
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• 1990

Most of the diagnostic methods currently used for the detection of neoplastic masses provide indirect evidence. To obtain greater specificity in the interpretation of neoplasias by in vivo methods, the immunological approach appears to be most promising. Two problems that interfered with progress in this field were the lack of tumor specific antigen and the lack of well-defined and reproducible antibodies. To improve the sensitivity and specificity of radioimmunoscintigraphy as a technique for tumor localization, the use of monoclonal antibodies, fragments of antibodies and single photon emission computerized tomography (SPECT) are reasonable. The obvious advantages of monoclonal antibodies are their homogeneity, their specificity for the immunizing antigen and the reaction with a single determinant-thus no large immunecomplexes with antigen are formed. Monoclonal antibody technique has recently provided an opportunity to reevaluate the role of nuclear medicine for the diagnosis of malignant diseases by using the immunological approach. Out first results by means of radioimmunoscintigraphy of CEA and CA 19-9 producing tumors using a cocktail of fragments F $(ab')_2$, of mocolonal antibodies to CA 19-9 and CEA labeled with $^{131}I$ (IMACIS-1) are reported. The aims of this investigation was to evaluate the role of immunoscintigraphy in patients with colorectal and other cancers for diagnosis of local recurrences and metastasis. This report contains results of the first 8 colorectal and pancreas cancer patients with the elevation of the level of serum CEA and/or CA 19-9. IMACIS-1 was injected intravenously during 30 minutes in 100 ml saline solution after skin test. Planar scintigrams were recorded 3, 5 and 7 days after the injection of the IMACIS-1. Anterior, lateral and posterior views of the liver as well as anterior and posterior views of the pelvis were obtained in each patients as an $^{131}I-antibody$ image. We were able to localize exactly the malignant process with the double-nuclide double-compound $^{99m}Tc\;^{131}I$ (Tc+l) scintigrams. In Tc & I double-nuclide scintigraphy, computer subtraction display provided more clear localization of the tumor. We compared the results of radioimmunoscintigraphy with CT, ultrasonograms, conventional scintigrams. The results were as follows: 1) The sensitivity and specificity of radioimmunoscintigraphy using the fragments $F(ab')_2$ of the cocktails of CEA and CA 19-9 monoclonal antibodies were 80% and 100% respectively. 2) Tumor detection rate was not proportionated to the level of serum tumor markets. 3) Second tracer technique was essential for tumor localization as an anatomic landmark using double-nuclide scintigraphy. 4) A slow infusion of the antibodies was necessary to prevent the formation of large immune complexes. 5) Tumor/non-tumor radioactivity was most elevated at 7 days delayed imaging. 6) Using planar scintigraphic technique of $^{131}I$ labeled monoclonal antibodies are possible for imaging most of the tumors.

• 핵의학기술
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• 제18권1호
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• pp.149-152
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• 2014

핵의학과 영상검사 후에 검체검사를 시행할 경우 결과값에 미치는 영향을 알아보기 위해 PET-CT, Gated Myocardial SPECT, DTPA GFR Scan을 시행하기 전 후에 채혈하여 Tumor marker (AFP,CEA,CA19-9), Hormone (TSH,T3,TG,TG Ab)검사를 시행하여 Difference를 구하였다. 대부분의 결과가 10% 이내의 차이를 나타냈지만 Table 7의 sample 2와 Table 8의 sample 1, sample 6, sample 8의 저 농도 값에서 20%를 넘는 차이를 나타내는 경우가 있었다. 그렇지만 cpm값은 Table 7의 sample 2는 984(전), 1057(후) Table 8의 sample 1은 243(전), 301(후) sample 6은 58(전), 64(후) sample 8은 258(전), 203(후)으로 매우 흡사한 값을 나타냈다. 이 같은 값을 바탕으로 볼 때 영상검사를 시행한 후에 검체검사를 시행하더라도 결과값에 미치는 영향은 없는 것으로 판단된다.