MARCELO TATIT SAPIENZA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
20 resultados
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- Prevalence of exclusive lower extremity metastases at 18F-NaF PET/CT(2015) ORDONES, Monique Beraldo; VALADARES, Agnes Araujo; DUARTE, Paulo Schiavom; SADO, Heitor Naoki; LIMA, Marcos Santos; CARVALHO, Giovanna; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoAbstract Objective: To evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at 18F-NaF PET/CT. Materials and Methods: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies. Results: No exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients. Conclusion: The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases.
- Clinical and Dosimetric Variables Related to Outcome After Treatment of Graves' Disease With 550 and 1110 MBq of I-131(2015) SAPIENZA, Marcelo Tatit; COURA-FILHO, George Barberio; WILLEGAIGNON, Jose; WATANABE, Tomoco; DUARTE, Paulo Schiavom; BUCHPIGUEL, Carlos AlbertoTherapy of Graves' hyperthyroidism (HTG) with I-131 is still mostly performed on an empirical basis. The present study was carried out to evaluate clinical and dosimetric variables associated with outcome in HTG therapy, which could contribute to planning and defining the most appropriate activity to be administered. Methods Patients with HTG were randomly assigned to therapy with 555 MBq (15mci) or 1110 MBq (30 mCi) of I-131. Estimation of thyroid radiation absorbed dose was made according to MIRD methodology. Success was defined as clinical/laboratory euthyroidism or hypothyroidism one year after therapy. The association between clinical, laboratory, and dosimetric variables with 1-year outcome was measured using bivariate analysis, followed by logistic regression. Results Ninety-one patients included completed the follow-up. Therapeutic success was observed in 77 (84.6%) of them, in a greater proportion when 1110 MBq of I-131 was administered as compared with 550 MBq (94.8% vs 77.4%, P = 0.02). Besides administered activity, multivariate analysis indicated that outcome was related to patient age and gland mass. A higher therapeutic success rate was achieved with doses greater than 300 Gy as compared with doses less than 300 Gy (89% vs 60%, P = 0.01). Conclusion Administered activity, age, and gland mass were related to the outcome. Radiation absorbed dose, although not significant according to multivariate analysis, may be used as a quantitative parameter in therapy planning, with a target dose of 300 Gy. In cases where a rapid and efficient response to radioiodine treatment is required, adoption of a simplified protocol employing high activities is justified.
- Complementary findings on 18F-FDG PET/CT and 18F-NaF PET/CT in a patient with Erdheim-Chester disease(2017) SABINO, Daniela; VALE, Romulo Hermeto Bueno do; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos Alberto
- Comparison of Oral and IV 18F-NaF PET/CT Administration in the Assessment of Bone Metastases in Patients With Breast or Prostate Cancers(2023) ROCHA, Nelisa Helena; ZACCHI, Samara Riguete; SADO, Heitor Naoki; BUCHPIGUEL, Carlos Alberto; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo TatitPurposeThe aim of this study was to compare oral and IV administrations of F-18-NaF PET/CT for detection of suspicious bone metastatic lesions of breast and prostate cancers.Patients and MethodsThirty-six patients with breast (n = 23) or prostate (n = 13) cancers and high risk for bone metastases were prospectively evaluated. All patients underwent 2 PET/CT studies after IV and oral F-18-NaF administration within a 2 to 23 days interval between them. The maximum SUVs from the same suspicious lesions (& LE;5 index lesions per patient) in both studies were measured. The target-to-background ratio (TBR), defined as the relation between the lesion maximum SUV and the whole skeletal mean SUV, was calculated for each lesion. The TBRs in the same lesion calculated using the 2 administration routes were compared. The agreements between 2 physicians in the definition of the number of lesions in both studies were also assessed using weighted & kappa;.ResultsOne hundred thirty-four pairs of lesions were analyzed. There was no significant statistical difference between the median TBRs (P = 0.212) for IV (10.33) and oral (10.85). Excellent intraobserver agreement was observed between IV and oral routes: weighted & kappa; of 1.0 (95% confidence interval, 0.92-1.0) and 0.92 (95% confidence interval, 0.81-0.99) for physicians 1 and 2, respectively. The interobserver coefficients were 0.82 and 0.87 for ""oral versus oral"" and ""IV versus IV,"" respectively.Conclusions(18)F-NaF PET/CT studies using oral and IV routes present comparable performance; thus, it is possible to use oral route in patients with difficult venous access.
- Comparison of standardized uptake values measured on 18F-NaF PET/CT scans using three different tube current intensities(2015) VALADARES, Agnes Araujo; DUARTE, Paulo Schiavom; WOELLNER, Eduardo Bechtloff; COURA-FILHO, George Barberio; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoObjective: To analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on 18FNaF PET/CT scans. Materials and Methods: A total of 254 18F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses covered 675 regions classified as normal (236 RH, 232 RF, and 207 LV1). Results: Mean SUV for each skeletal region was 3.8, 5.4 and 14.4 for RH, RF, and LV1, respectively. As the studies were grouped according to mAs value, the mean SUV values were 3.8, 3.9 and 3.7 for 10, 20 and 30 mAs, respectively, in the RH region; 5.4, 5.5 and 5.4 for 10, 20 and 30 mAs, respectively, in the RF region; 13.8, 14.9 and 14.5 for 10, 20 and 30 mAs, respectively, in the LV1 region. Conclusion: The three tube current values yielded similar results for SUV calculation.
- Iodine/FDG ""Flip-Flop"" Phenomenon Inside a Large Metastatic Thyroid Cancer Lesion Better Characterized on SPECT/CT and PET/CT Studies(2018) DUARTE, Paulo Schiavom; MARIN, Jose Flavio Gomes; CARVALHO, Jose Willegaignon de Amorim de; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoIodine/FDG flip-flop phenomenon inside large metastatic thyroid cancer lesions has been rarely described. We present a case of this phenomenon better characterized using SPECT/CT and PET/CT studies.
- PET/CT Study Performed After an Oral Administration of F-18-Fluoride(2013) ZACCHI, Samara Riguete; VALADARES, Agnes Araujo; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoA 52-year-old woman with right breast cancer was referred for F-18-fluoride whole-body PET/CT for the assessment of bone metastases. The peripheral IV access was not obtained after multiple attempts. The radiopharmaceutical was administered by oral route.
- Preliminary Comparison of PET/CT Studies Performed After Intravenous and Oral Administration of F-18-Fluoride(2016) ZACCHI, Samara Riguete; VALE, Romulo Hermeto Bueno do; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoA 78-year-old man with prostate cancer was referred for F-18-NaF PET/CT for assessing bone metastases. An F-18-NaF PET/CT study was performed after the intravenous administration of the radiopharmaceutical. Five days later, a second study was done after oral administration of the radiopharmaceutical as part of a research protocol.
- Bone and Calcified Soft Tissue Metastases of Medullary Thyroid Carcinoma Better Characterized on F-18-Fluoride PET/CT than on Ga-68-Dotatate PET/CT(2018) DUARTE, Paulo Schiavom; CASTRONEVES, Luciana Audi de; SADO, Heitor Naoki; SAPIENZA, Marcelo Tatit; HOFF, Ana Amelia Fialho de Oliveira; BUCHPIGUEL, Carlos AlbertoHerein, we report a case of a 19-year-old man with multiple endocrine neoplasia type 2B (MEN2B) and medullary thyroid carcinoma (MTC) diagnosed when he was 12 years of age. The patient had previously undergone total thyroidectomy, cervical radiotherapy, and chemotherapy. He progressed with known bone, pulmonary, and lymph node metastases and was scanned with F-18-fluoride (F-18-NaF) and Ga-68-dotatate whole-body positron emission tomography/computed tomography (PET/CT) for metastatic disease monitoring. We found that the MTC bone metastases and soft tissue calcified metastases were better characterized on F-18-NaF PET/CT than on Ga-68-dotatate PET/CT. This case illustrates that the F-18-NaF PET/CT could be helpful not only to the detection of bone metastases but also to the detection of calcified soft tissue metastases in patients with MTC.
- Whole-Skeleton SUVmean Measured on F-18-NaF PET/CT Studies as a Prognostic Indicator in Patients with Breast Cancer Metastatic to Bone(2022) MARIN, Jose Flavio Gomes; DUARTE, Paulo Schiavom; ORDONES, Monique Beraldo; SADO, Heitor Naoki; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoIn this work, we assessed the association between the whole-skeleton SUVmean measured on F-18-NaF PET/CT studies and overall survival (OS) in patients with breast cancer metastatic to bone. Methods: We retrospectively analyzed 176 patients with breast cancer and metastatic bone disease who underwent F-18-NaF PET/CT. The outcomes of the patients (dead or alive) were based on the last information available in their files. The SUVmean and SUVmax were measured in a whole-skeleton volume of interest (wsVOI). The wsVOI was based on the CT component of the PET/ CT study using Hounsfield unit thresholds. The wsVOI was then applied to the F-18-NaF PET image. Univariate analyses were performed to assess the association of SUVs with OS. We also analyzed the association between OS and patient age; presence of visceral metastatic disease; histologic subtype; presence of hormone receptors; human epidermal growth factor receptor 2 expression; and creatinine, cancer antigen (CA) 15-3, and alkaline phosphatase levels. The variables statistically significant in the univariate analyses were included in a multivariate Cox regression OS analysis. Results: In the univariate analyses, there were associations between OS and whole-skeleton SUVmean and SUVmax, estrogen receptor status, and CA15-3 and alkaline phosphatase levels. In the multivariate analysis, all variables that were statistically significant in the univariate analyses were associated with OS, with the exception of CA15-3. Conclusion: In patients with breast cancer metastatic to bone, whole-skeleton SUVmean is an independent predictor of OS.