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M9470076.TXT
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1994-07-02
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Document 0076
DOCN M9470076
TI Immunoscintigraphy of Pneumocystis carinii pneumonia in AIDS patients
[see comments]
DT 9409
AU Goldenberg DM; Sharkey RM; Udem S; Vagg R; Levine GM; Conte P; Swayne
LC; Hansen HJ; Cunniff D; Anton J; et al; Garden State Cancer Center at
Center for Molecular Medicine and; Immunology, Newark, New Jersey 07103.
SO J Nucl Med. 1994 Jun;35(6):1028-34. Unique Identifier : AIDSLINE
MED/94253898
CM Comment in: J Nucl Med 1994 Jun;35(6):1034-7
AB The diagnosis of Pneumocystis carinii pneumonia (PCP) currently relies
upon cytological demonstration of the organism in sputum or bronchoscopy
specimens. The purpose of this study was to develop a radiolabeled
monoclonal antibody (Mab) against Pneumocystis carinii (P. carinii) and
to evaluate its use for imaging PCP. METHODS: We studied 16 HIV-infected
patients with pneumonia in order to evaluate a new Mab-based imaging
method for diagnosing PCP. Most patients were managed for opportunistic
pneumonia associated with AIDS, including standard cytological tests,
and, in all cases, intensive chemotherapy. Prior to the clinical study,
the Mab raised to P. carinii was shown to react with human P. carinii
but not with rat P. carinii or human white blood cells. RESULTS: After
labeling a 1-mg Mab Fab' fragment with 30 mCi of 99mTc, the presence or
absence of PCP could be confirmed in six of seven or seven of eight
assessable patients, respectively, by external photoscanning within 24
hr. This shows a sensitivity of 85.7% and a specificity of 86.7%.
CONCLUSION: Our findings suggest that PCP can be diagnosed by a
noninvasive imaging method employing a small dose of a 99mTc-labeled Mab
showing specificity for the infectious organism, since patients with P.
carinii-free pneumonia were correctly negative in 87.5% of cases. Rapid
diagnosis and organ-localization of other infectious lesions with
organism-specific, radiolabeled Mabs may be feasible.
DE Adult Antibodies, Monoclonal/DIAGNOSTIC USE AIDS-Related Opportunistic
Infections/RADIOGRAPHY/*RADIONUCLIDE IMAGING Female Human Iodine
Radioisotopes/DIAGNOSTIC USE Lung/RADIOGRAPHY/RADIONUCLIDE IMAGING
Male Pneumonia, Pneumocystis carinii/RADIOGRAPHY/*RADIONUCLIDE IMAGING
*Radioimmunodetection Support, U.S. Gov't, Non-P.H.S. Support, U.S.
Gov't, P.H.S. Technetium/DIAGNOSTIC USE JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).