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Radioimmunodetection of Cancer with Radiolabeled Antibodies to -Fetoprotein¹

Division of Nuclear Medicine, Department of Radiation Medicine [E. E. K., F. H. D., G. S.], Department of Medicine [M. O. N.], Division of Experimental Pathology, Department of Pathology [S. B., D. M. G.], University of Kentucky College of Medicine, Veterans Administration Medical Center, Ephraim McDowell Community Cancer Network, Inc., Lexington, Kentucky 40536, and Gastrointestinal Unit, Massachusetts General Hospital, Boston 02114 [E. A.], and Department of Medicine [E. A.], Harvard Medical School, Boston, Massachusetts 02115

Sixteen patients with histologically proven malignant neoplasia were investigated by radioimmunodetection, using goat anti--fetoprotein (AFP) antibody radiolabeled with ¹³¹I. Images of the chest and abdomen were made with a scintillation camera, usually at 24 and 48 hr following injection of 1 to 2.5 mCi of radioiodinated antibody. Computer-assisted processing for the subtraction of ^99mTc background radioactivity was used to enhance the detection and localization of tumors visualized by immune scintigraphy. All 12 sites involved by five AFP-producing tumors could be demonstrated by radioimmunodetection, while normal goat immunoglobulin G labeled with ¹³¹I failed to show similar results in one of the patients in whom the radioactive AFP antibody achieved tumor radiolocalization. Five patients in whom the tumors were not expected to produce AFP also had their large tumors demonstrated by immune scintigraphy in 6 of 16 tumor sites. The average tumor to non-tumor ¹³¹I image count density ratios were 3.20 and 1.96 for the AFP-containing and putatively AFP-deficient tumors, respectively. The image contrast was significantly greater for the AFP-containing tumors, and the subtraction technique enhanced the image contrast more than 2-fold. Based upon these initial results, the sensitivity of the method (true-positive rate) was 100%, its specificity (true-negative rate) was 80%, and the accuracy of the technique was 85%. This study thus indicates that radioimmunodetection of cancer with radioactive AFP antibodies can be useful in the evaluation of patients with AFP-containing neoplasms.

¹ Presented at the UICC Workshop on Radioimmunodetection of Cancer, July 19 to 21, 1979, Lexington, Ky. Although this particular study was not performed as a part of our current grant support, background studies were supported in part by NIH Grants CA-17742, CA-25584, and CA-12389, NIH Contract NCI-NO1-CB-64011-35, and by the Veterans Administration.

² To whom requests for reprints should be addressed, at the Division of Experimental Pathology, University of Kentucky College of Medicine, MS-409, Lexington, Ky. 40536.