[Immunoguided surgery]

Radioimmunoguided surgery has been attempted using intraoperative tumor detection with radiolabeled monoclonal antibody (mAb). Directly radiolabeled mAb showed poor tumor imaging due to high blood-pool radioactivity. In 1991, three-step immunoscintigraphy of the avidin-biotin system was reported. This three-step method improved tumor imaging because it reduced background radioactivity. Although there were some problems such as a human anti-mouse response and anti-avidin response, the three-step clinical protocol was performed in various cancer patients, and many good results (the tumor detection rate was about 85%) were reported. On the other hand, recent major trials on tumor localization and sentinel lymph node detection have been performed using FDG-PET. However, radioimmunoscintigraphy has the major advantage of simultaneous tumor diagnosis and treatment. In the near future, radioimmunoscintigraphy may become a useful diagnostic method with anticancer effects when its adverse effects are ameliorated by the application of gene technology.