THE DIAGNOSTIC-VALUE OF IMMUNOSCINTIGRAPH Y WITH 99TCM-LABELED MONOCLONAL-ANTIBODY 174H.64 IN HEAD AND NECK CARCINOMAS

Twenty-one patients with squamous cell carcinomas of the head and neck were studied by immunoscintigraphy and immuno-emission, computed tomo graphy (ECT) using monoclonal antibody 174H.64 (Biomira Edminton) labe lled with 99Tcm (Schwartz Method). Immunoscintigraphic results were co mpared with routine clinical assessments, including CT and ultrasonogr aphy, and were controlled by histopathological examination after surge ry. All primary localizations (pT1 = 3, pT2 = 3, pT3 = 7, pT4 = 5; oro pharynx 7, larynx 5, hypopharynx 3, oral cavity 3, lymph nodes 3) coul d be visualized, while 15 out of 18 neck lesions from tumor metastases could also be visualized (pN1 = 8, pN2 = 8, pN3 = 2). In one case wit h micrometastases in lymph nodes that could not be demonstrated by oth er methods, staging was upgraded by the immunoscintigraphic results. T hree other micrometastases in lymph nodes could not be visualized. Dis tant metastases were suspected in 5 cases, three of which were confirm ed either histologically or by radiography. Two of the cases with dist ant metastases were detected by the immunoscintigraphy. The present re sults indicate that immunoscintigraphy in combination with immuno-ECT can improve preoperative staging of head and neck carcinomas, especial ly with regard to metastatic neck disease, tumor recurrences and some cases of distant metastases.