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November 1991

Intraoperative Gamma Detection Probe With Presurgical Antibody Imaging in Colon Cancer

Author Affiliations

From the Departments of Surgery (Drs Kuhn, Corbisiero, Buras, Wagman, and Beatty and Ms Smith), Radiation Research (Dr Wilson), Radiology (Dr Yamauchi), and Biostatistics (Mr Kondo), City of Hope National Medical Center, Duarte, Calif, and Carewise Medical Products Inc, Morgan Hill, Calif (Dr Carroll). Dr Beatty is now with the National Cancer Institute of Canada, Toronto, Ontario.

Arch Surg. 1991;126(11):1398-1403. doi:10.1001/archsurg.1991.01410350092013

• In this study, presurgical gamma camera imaging and an intraoperative gamma detection probe were used in 12 consecutive patients 6 to 22 days after infusion with indium 111–labeled anticarcinoembryonic antigen monoclonal antibody (111In-MoAb). In three of 11 patients who underwent laparotomy, clinical management was affected by the probe findings: localization of occult retroperitoneal disease, identification of an occult cecal lesion, and localization of residual disease at a site of local recurrence. Of all intra-abdominal lesions seen using any method, the probe identified 18 (86%) of 21, compared with 14 (67%) of 21 with the111In-MoAb scan, 10 (48%) of 21 by computed tomographic scan, and 16 (76%) of 21 after surgical exploration. Uptake of111In-MoAb in the portal (n=3) and mediastinal (n=3) lymph nodes was not associated with histologic findings of malignant neoplasms. For all pathologically confirmed extrahepatic and nonportal sites of cancer, the probe localized nine of nine, compared with five of nine by111In-MoAb scan, two of nine by computed tomographic scan, and six of nine by surgical exploration. Important clinical uses of the intraoperative probe included occult lesion identification, localization of areas with111In uptake shown with MoAb scanning, and verification of complete resection of areas with111In-MoAb uptake.

(Arch Surg. 1991;126:1398-1403)

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