Fourteen patients with gastric lesions were studied for radioimmunoscintigraphy using the 99mTc-ccM4 chimeric antibody reactive with the human tumor-associated TAG72 antigen. These include 10 gastric adenocarcinomas, 3 gastric ulcers and 1 gastric lymphoma. Each patient received an infusion of 30-40 mCi 99mTc-ccM4 antibody. Gamma camera scans were performed at 12-h postadministration. All patients underwent operation after radioimmunoscintigraphy. All surgical specimens including gastric adenocarcinomas, lymphoma and ulcers were confirmed by histopathological studies. The 99mTc-ccM4 antibody was able to detect 6 out of 10 gastric adenocarcinomas (60%) by scans. Its accuracy was even 5 out of 6 (83%) in a group of patients with well/moderately-differentiated adenocarcinomas. In addition to the primary adenocarcinomatous lesions, the 99mTc-ccM4 antibody was also able to detect metastatic lesions in liver and lymph nodes. The smallest adenocarcinomatous lesion detected by scans was about 1 x 1 x 2 cm3. All four patients with gastric ulcers or lymphoma showed negative scan results. Therefore, the chimeric ccM4 antibody may be useful in radioimmunoscintigraphy of gastric adenocarcinomas, especially the well/moderately-differentiated adenocarcinomas.