Preoperative diagnosis of ovarian carcinoma with a novel monoclonal antibody

OBJECTIVE: This study was undertaken to determine whether preoperative radi oimmunoscintigraphy of complex ovarian masses with technetium Tc 99m MAb-17 0 (Tru-Scint AD; Biomira Inc, Edmonton, Alberta, Canada), a murine whole im munoglobulin G monoclonal antibody that has been found to have panadenocarc inoma affinity, would predict surgical findings. STUDY DESIGN: The age range of studied patients was 42 to 83 years (mean, 6 0.3 years). Planar computed tomographic imaging and single-photon emission computed tomographic imaging were performed at 15 minutes, 6 to 8 hours, an d 18 to 24 hours after injection of 1000 MBq technetium Tc 99m MAb-170. Lap arotomy was performed within 10 days. RESULTS: Eighteen patients had borderline or invasive ovarian cancers verif ied by histologic examination. All primary malignancies or deposits (includ ing intrahepatic deposits) yielded positive results on radioimmunoscintigra phic imaging. Radioimmunoscintigraphy was able to identify serosal deposits not seen on computed tomographic or ultrasonographic scans. False-positive localization of the antibody was noted in 6 of the 9 patients with benign pathologic processes. CONCLUSION: It is possible to detect with technetium Tc 99m MAb-170 all pat ients who have cancer (including sites not seen on computed tomographic or ultrasonographic scan); however, the low specificity (33%) means that patie nts still require surgical verification of disease.