Mj. Blend et al., RADIOIMMUNOSCINTIGRAPHY IN PATIENTS WITH EARLY-STAGE CUTANEOUS MALIGNANT-MELANOMA, The Journal of nuclear medicine, 37(2), 1996, pp. 252-257
CT and MRI examinations remain relatively insensitive for the detectio
n of metastatic melanoma lesions, especially those of regional lymph n
odes. Imaging cutaneous malignant melanoma patients with the Fab fragm
ent of monoclonal antibody (MAb) NR-ML-05 labeled with Tc-99m has been
reported to increase the accuracy of staging. Our purpose in this stu
dy was to assess the sensitivity of Tc-99m-labeled NR-ML-05 in detecti
ng the spread of melanoma. Methods: Twenty-six adult cutaneous maligna
nt melanoma patients were enrolled in this study and were followed for
6 to 60 mo after radioimmunoscintigraphy. At the time of imaging, 20
patients had their primary lesions resected, whereas the remaining 6 p
atients had their primary lesions intact. Results: Radioimmunoscintigr
aphy correctly detected 8 of 18 suspicious lesions as malignant, as we
ll as 4 additional malignant lesions which had not been suspected prev
iously. Radioimmunoscintigraphy also correctly identified 8 of the 18
suspicious lesions as benign. Two of the 18 suspicious lesions were fo
und to be false negatives. The overall lesion sensitivity of radioimmu
noscintigraphy was 86%. Conclusion: Twenty-four of the 26 patients wer
e correctly staged by radioimmunoscintigraphy. The accuracy of staging
of cutaneous malignant melanoma patients by clinical and or radiologi
c examinations (73%) was greatly improved with the use of radioimmunos
cintigraphy (93%). These results suggest that radioimmunoscintigraphy
may be a clinically useful adjunct to the current armamentarium for gu
idance of medical, and particularly surgical, therapy of cutaneous mal
ignant melanoma patients.