Comparison of immunoscintigraphy and computerized tomography in identifying colorectal cancer : individual lesion analysis

• Published in: Cancer research (Chicago, Ill.) Vol. 51; no. 20; pp. 5704 - 5711
• Main Authors: CORBISIERO, R. M, YAMAUCHI, D. M, WILLIAMS, L. E, ESTEBAN, J. M, ODOM-MARYON, T, BEATTY, J. D
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 15.10.1991
• Subjects: Abdominal Neoplasms - diagnostic imaging; Abdominal Neoplasms - secondary; Antibodies, Monoclonal; Biological and medical sciences; Carcinoembryonic Antigen - immunology; Colorectal Neoplasms - diagnostic imaging; Colorectal Neoplasms - pathology; Digestive system; Humans; Indium Radioisotopes; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radioimmunodetection; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Human; Radiodiagnosis; Gut; Exploration; Scintigraphy; Malignant tumor; Immunoradiodiagnosis; Rectum; Digestive diseases; Computerized axial tomography; Colon; Diagnosis; Comparative study
• ISSN: 0008-5472; 1538-7445

Monoclonal antibody scintigraphy with 111In-ZCE025 was used in presurgical staging of 45 patients prior to abdominal exploration for primary, recurrent or metastatic colorectal carcinoma. A total of 186 lesions were identified, of which 147 were evaluated by abdominal surgery and pathology. Sensitivity was 40.5% (49 of 121) for immunoscintigraphy (IS), 61.2% (74 of 121) for computerized tomography (CT), and 72.7% (88 of 121) for IS and CT combined. The positive predictive value was 83.1% (49 of 59) for IS and 88.1% (74 of 84) for CT. Sensitivity of IS was 100% (23 of 23) for primary tumors, 17.7% (11 of 62) for hepatic metastases, and 41.7% (15 of 36) for extrahepatic abdominal metastases. Of the 50 hepatic lesions evaluated by single-proton emission computerized tomography, 11 were localized by IS. Only one was visualized by planar scintigraphy. Sensitivity of CT was 87% (20 of 23) for primary tumors, 67.7% (42 of 62) for hepatic metastases, and 33.3% (12 of 36) for extrahepatic abdominal metastases. Sensitivity of IS combined with CT was 72.6% (45 of 62) for hepatic and 55.6% (20 of 36) for extrahepatic abdominal metastases. Of 24 malignant lesions measured by the pathologist to be less than 3.0 cm (maximum dimension), 7 (29.2%) were detected by IS and 3 (12.5%) by CT. Of 28 malignant lesions greater than 3.0 cm, 23 (82.1%) were detected by IS and 24 (85.7%) by CT. Overall, IS and CT complemented each other in presurgical staging of colorectal carcinoma. IS was of greater value for identification of extrahepatic and small metastases. CT was more effective for identification of hepatic metastases.