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Radiology, Vol 197, 688-692, Copyright © 1995 by Radiological Society of North America

ARTICLES

Detection of pelvic recurrence of colorectal carcinoma: prospective, blinded comparison of Tc-99m-IMMU-4 monoclonal antibody scanning and CT

PC Stomper, DJ D'Souza, SP Bakshi, M Rodriguez-Bigas, PA Burke and NJ Petrelli
Department of Diagnostic Imaging, Roswell Park Cancer Institute, School of Medicine and Biomedical Sciences, State University of New York at Buffalo 14263, USA.

PURPOSE: To prospectively compare the accuracy of imaging with technetium-99m-labeled Fab' fragment of the anti-carcinoembryonic antigen antibody (CEA) IMMU-4 with that of computed tomography (CT) for the detection of pelvic recurrence of colorectal carcinoma. MATERIALS AND METHODS: In 61 patients, blinded interpretations of both modalities were correlated with surgical-pathologic (n = 23) or clinical and CT follow-up findings (n = 38). RESULTS: Sensitivity and specificity with antibody scanning alone and combined with CT (79% and 84% vs 83% and 81%, respectively) were not significantly different from those values for CT alone (66% and 97%, respectively). Sensitivity of antibody scanning was greater for recurrences larger than 2 cm (94% vs 55% [P = .02]), serum CEA more than 2.5 ng/mL (91% vs 40% [P = .03]), and combined planar and single photon emission CT antibody scanning compared with planar alone (79% vs 48% [P = .03]), without a significant decrease in specificity. CONCLUSION: Antibody scanning does not improve on findings at CT alone for recurrent colorectal carcinoma but can help differentiate recurrent tumor from fibrosis.


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