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).