Radioimmunoscintigraphy with Tc-99m-labelled SM3 in differentiating malignant from benign adnexal masses

N. Ali, H. Jan, P. Van Trappen, F. Nasreen, A. Canizales, M. J. Carroll, M. Granowska, I. Jacobs, K. E. Britton

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objective: Ultrasound scanning, serum CA125 and menopausal status have previously been combined in a risk of malignancy index for the differential diagnosis of adnexal masses. Although this approach has greater accuracy than either individual tests or clinical assessment, it has a significant false positive and false negative rate. Efforts have been directed at refining differential diagnosis and this study assessed the role of radioimmunoscintigraphy using the stripped mucin 3 (SM3) antibody that has a 17-fold greater uptake in malignant than benign ovarian tumours in vitro. Design: Prospective study of patients with a pelvic mass using radioimmunoscintigraphy. Setting: Department of Nuclear Medicine of St Bartholomew's Hospital in collaboration with Cancer Network. Population: A total of 93 patients with pelvic masses were recruited for this study of which 32 had ovarian cancer and 61 had benign lesions. Methods: Radioimmunoscintigraphy was performed with Tc-99m-labelled SM3 (600 MBq), anterior and posterior pelvis imaged at 10 minutes and at 4 and 24 hours and evaluated with change detection analysis and probability mapping. Main outcome measures: Sensitivity and specificity of radioimmunoscintigraphy for ovarian cancer. Results: Radioimmunoscintigraphy had a sensitivity for ovarian cancer of 84% (27 true positive and 5 false negatives) and a specificity of 87% (53 true negatives and 8 false positives) giving a negative predictive value of 91%. Conclusion: These results suggest that radioimmunoscintigraphy could be used to reduce the number of false positive findings in a strategy to refine differential diagnosis of the pelvic mass.
    Original languageEnglish
    Pages (from-to)508-514
    Number of pages6
    JournalBJOG: An International Journal of Obstetrics and Gynaecology
    Volume110
    Issue number5
    DOIs
    Publication statusPublished - 1 May 2003

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