Page 57 - 89Zr-Immuno-PET:Towards a Clinical Tool to Guide Antibody-based Therapy in Cancer

Immuno-PET with 89Zr-cMab U36 in head and neck cancer
Table 2. Correlation of Preoperative Findings with Histopathologic Findings per Level
121 operated levels 25 tumors involved
Palpation CT/MRI 89Zr-immuno-PET
Sensitivity
11/25 = 44% 15/25 = 60% 18/25 = 72%
Specificity
96/96 = 100% 94/96 = 98% 94/96 = 98%
ACCURACY
107/121 = 88% 109/121 = 90% 112/121 = 93%
Table 3. Correlation of Preoperative Findings with Histopathologic Findings per Side 3 25 operated sides Sensitivity Specificity ACCURACY
15 tumors involved
Palpation 8/15 = 53% 10/10 = 100% 18/25 = 72% CT/MRI 11/15 = 73% 9/10 = 90% 20/25 = 80% 89Zr-immuno-PET 11/15 = 73% 8/10 = 80% 19/25 = 76%
Six patients also underwent FDG-PET. For these patients, the sensitivity of immuno-PET and FDG-PET for detection of tumor-involved lymph node levels was 85% and 62%, respectively (Table 4).
False-positive findings were obtained with immuno-PET (two levels), CT (two levels), and MRI (one level). No false-positive cases were observed with palpation and FDG-PET.
The paraffin slides of the seven tumor-involved lymph node levels that had been missed with immuno-PET were reexamined by histopathologic examination (Table 5). The tumor-involved lymph nodes found in these levels were relatively small, and contained just a small proportion of tumor tissue. No necrosis was observed in these tumors. Six of seven tumor-involved lymph node levels that had been missed by immuno-PET, were also missed by CT and/or MRI. The smallest tumor involved lymph node detected by immuno-PET was 5 x 5 mm, with 75% tumor involvement.
Table 4. Correlation of Preoperative Findings with Histopathologic Findings per Level in six Patients who Received FDG-PET
40 operated levels 13 tumors involved
Palpation CT/MRI FDG-PET 89Zr-immuno-PET
Sensitivity
7/13 = 54% 10/13 = 77% 8/13 = 62% 11/13 = 85%
Specificity
27/27 = 100% 27/27 = 100% 27/27 = 100% 27/27 = 100%
ACCURACY
34/40 = 85% 37/40 = 93% 35/40 = 88% 38/40 = 95%
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