Although intraoperative radioimmunolocalization (IORIL) is gaining wider acceptance, several limits inhibit a more extensive clinical use.
In this paper the following topics will be discussed: 1) the clinical approach, that is, the combined use of immunoscintigraphy and IORIL after a single MAb administration or the use of non-imaging 125 I MAb; 2) the detector type and its collimation and shielding; 3) the nuclides employed, and 4) the background problem.
The clinical results of our and other groups show a sensitivity that is generally higher than 0.75 with a high positive predictive value. The detection rate of occult lesions is in the order of 20% of all explored sites. However, the current state of detector and MAb technology do not allow to achieve better results; probably the results can be improved by the use of bispecific MAb or the avidin-biotin system.
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