Ralph J. Doerr

Bio: Ralph J. Doerr is an academic researcher from United States Department of Veterans Affairs. The author has contributed to research in topics: Antigen & Monoclonal. The author has an hindex of 1, co-authored 1 publications receiving 33 citations.

Indium 111 ZCE-025 immunoscintigraphy in occult recurrent colorectal cancer with elevated carcinoembryonic antigen level.

Abstract: • We investigated the utility of scanning with indium 111 labeled to monoclonal antibody in 13 patients after curative resection of colorectal cancer who had elevated carcinoembryonic antigen levels and negative results of clinical workup. Each patient received 1 mg of anti–carcinoembryonic antigen monoclonal antibody type ZCE 025 labeled with 5.5 mCi of111In, plus 9 to 39 mg of the same antibody unlabeled. Patients underwent scanning 3 to 7 days after infusion by planar and emission computed tomography. ZCE-025 monoclonal antibody imaging detected tumor recurrence or metastasis in 11 of 13 patients. In one patient the monoclonal antibody scan gave a true-negative result, and in one patient the monoclonal antibody scan failed to disclose a metachronous cecal primary. Tumor sites identified were the pelvis (2 patients), abdominal wall (2), retroperitoneum (1), lymph nodes (3), liver (2), bone (2), and lung (1). The accurate localization of colorectal carcinoma recurrences by means of111In ZCE-025 monoclonal antibody demonstrates the usefulness of this diagnostic agent in the setting of elevated carcinoembryonic antigen level and negative results of clinical and radiologic workup. (Arch Surg. 1990;125:226-229)

Preoperative staging of rectal carcinoma.

Abstract: Background: The development of treatment modalities for rectal cancer, including local excision, total mesorectal excision and preoperative radiotherapy, has increased the importance of accurate preoperative staging to allow the optimum treatment to be selected. Methods: A literature review was undertaken of methods of preoperative staging of rectal carcinoma and the evidence for each was evaluated critically. Results: Clinical assessment of rectal carcinoma may give an indication of fixity but is not accurate for staging. Endoanal ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), radioimmunoscintigraphy and positron emission tomography have all been used for staging. The extent of tumour spread through the bowel wall (T stage) is most accurately assessed by endoanal ultrasonography, although this technique is poor at assessing tumour extension into adjacent organs for which both CT and MRI are more accurate. No method accurately determines lymph node involvement, but endoanal ultrasonography is the best available. Liver metastases may be assessed by abdominal ultrasonography, CT, MRI and CT portography (with increasing sensitivity and cost in that order). Conclusion: Endoanal ultrasonography is the most effective method of local tumour staging, with the addition of either CT or MRI if adjacent organ involvement is suspected. Abdominal ultrasonography or CT is recommended for routine preoperative assessment of the liver. © 1999 British Journal of Surgery Society Ltd

Radioimmunoguided surgery using iodine 125 b72.3 in patients with colorectal cancer

Abstract: • Preliminary data using B72.3 murine monoclonal antibody labeled with iodine 125 suggested that both clinically apparent as well as occult sites of colorectal cancer could be identified intraoperatively using a hand-held gamma detecting probe. We report the preliminary data of a multicenter trial of this approach in patients with primary or recurrent colorectal cancer. One hundred four patients with primary, suspected, or known recurrent colorectal cancer received an intravenous infusion of 1 mg of B72.3 monoclonal antibody radiolabeled with 7.4×10 Bq of iodine 125. Twenty-six patients with primary colorectal cancer and 72 patients with recurrent colorectal cancer were examined. Using the gamma detecting probe, 78% of the patients had localization of the antibody in their tumor; this included 75% of primary tumor sites and 63% of all recurrent tumor sites; 9.2% of all tumor sites identified represented occult sites detected only with the gamma detecting probe. The overall sensitivity was 77% and a predictive value of a positive detection was 78%. A total of 30 occult sites in 26 patients were identified. In patients with recurrent cancer, the antibody study provided unique data that precluded resection in 10 patients, and in another eight patients it extended the potentially curative procedure. ( Arch Surg . 1991;126:349-352)

The carcinoembryonic antigen (CEA): Past, present, and future

Abstract: N/A