MARCELO TATIT SAPIENZA

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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

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  • article 6 Citação(ões) na Scopus
    Estimating 131I biokinetics and radiation doses to the red marrow and whole body in thyroid cancer patients: probe detection versus image quantification
    (2016) WILLEGAIGNON, José; PELISSONI, Rogério Alexandre; LIMA, Beatriz Christine de Godoy Diniz; SAPIENZA, Marcelo Tatit; COURA-FILHO, George Barberio; QUEIROZ, Marcelo Araújo; BUCHPIGUEL, Carlos Alberto
    Abstract Objective: To compare the probe detection method with the image quantification method when estimating 131I biokinetics and radiation doses to the red marrow and whole body in the treatment of thyroid cancer patients. Materials and Methods: Fourteen patients with metastatic thyroid cancer, without metastatic bone involvement, were submitted to therapy planning in order to tailor the therapeutic amount of 131I to each individual. Whole-body scans and probe measurements were performed at 4, 24, 48, 72, and 96 h after 131I administration in order to estimate the effective half-life (Teff) and residence time of 131I in the body. Results: The mean values for Teff and residence time, respectively, were 19 ± 9 h and 28 ± 12 h for probe detection, compared with 20 ± 13 h and 29 ± 18 h for image quantification. The average dose to the red marrow and whole body, respectively, was 0.061 ± 0.041 mGy/MBq and 0.073 ± 0.040 mGy/MBq for probe detection, compared with 0.066 ± 0.055 mGy/MBq and 0.078 ± 0.056 mGy/MBq for image quantification. Statistical analysis proved that there were no significant differences between the two methods for estimating the Teff (p = 0.801), residence time (p = 0.801), dose to the red marrow (p = 0.708), and dose to the whole body (p = 0.811), even when we considered an optimized approach for calculating doses only at 4 h and 96 h after 131I administration (p > 0.914). Conclusion: There is full agreement as to the feasibility of using probe detection and image quantification when estimating 131I biokinetics and red-marrow/whole-body doses. However, because the probe detection method is inefficacious in identifying tumor sites and critical organs during radionuclide therapy and therefore liable to skew adjustment of the amount of 131I to be administered to patients under such therapy, it should be used with caution.
  • article 6 Citação(ões) na Scopus
    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
  • article 0 Citação(ões) na Scopus
    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 Tatit
    PurposeThe 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.
  • article 3 Citação(ões) na Scopus
    Correlação entre volume tireoidiano determinado pelo método de ultrassonografia versus cintilografia e sua implicação em cálculos dosimétricos na terapia com radioiodo na doença de Graves
    (2011) VIEIRA, Lucas de Oliveira; KUBO, Rodrigo; SAPIENZA, Marcelo Tatit; WILLEGAIGNON, Jose; CHAMMAS, Maria Cristina; COURA-FILHO, George Barberio; ONO, Carla Rachel; WATANABE, Tomoco; SADO, Heitor Naoki; BUCHPIGUEL, Carlos Alberto
    Introduction: Graves disease (GD) is the most common cause of hiperthyroidism, and the most common treatment options are surgery, antithyroid drugs and radioiodine therapy. In radiodosimetric calculations to determine radioiodine dosage it is possible to use thyroid volume estimatives based on ultrasound or scintigraphy. Objective: The present study aimed to correlate these methodologies emphasizing volume estimatives and dosimetric implications. Subjects and methods: Were included 103 patients with GD diagnosis and indication of radioiodine treatment. They were submitted to thyroid ultrasound and thyroid scintigraphy. Results and conclusions: Good correlation between both methods was observed, although scintigraphy systematically obtained greater volumes than ultrasound implying in lower estimatives of absorbed dose when scintigraphy is used. Arq Bras Endocrinol Metab. 2011;55(9):696-700
  • article 0 Citação(ões) na Scopus
    Repeatability of brown adipose tissue activation measured by [18F]FDG PET after beta3-adrenergic stimuli in a mouse model
    (2023) FARIA, Daniele de Paula; VERA, Cleinando Clemente da Silva; MARQUES, Fabio Luiz Navarro; SAPIENZA, Marcelo Tatit
    This study aimed to evaluate the repeatability of brown adipose tissue (BAT) activation measured by [F-18]FDG-PET after beta3-adrenergic stimuli with CL316243 in mice.Methods: Male C57BL/6 mice underwent [F-18]FDG-PET at baseline without stimulation (T0-NS), on three consecutive days after intravenous administration of the selective beta 3-adrenergic agonist CL316243 (T1-CL, T2-CL, T3-CL), and without stimuli after 1 and 2 weeks (T7-NS and T14-NS). The standardized uptake value (SUVmax), BAT metabolic volume (BMV), and total BAT glycolysis (TBG) were measured in each scanning session, with statistical groupwise comparisons by ANOVA and post hoc Tukey test.Results: SUVmax, BMV, and TBG values showed no significant differences between the three PET scans without stimuli, but were significantly higher after CL316243 administration (p < 0.0001). The mean coefficient of variation (CoV) of PET within individuals was 49 % at baseline but only 9 % with pharmacological stimulation.Conclusions: The study demonstrated that administration of the selective beta 3-adrenergic receptor agonist CL316243 (CL) in mice leads to consistent metabolic activation of brown adipose tissue (BAT), as measured by [F-18]FDG-PET. We also demonstrated metabolic activation by repeated pharmacological challenge, without evidence of hysteresis. Thus, the methods used in the current work should serve for further studies on BAT metabolism in experimental animals, with translational value for clinical research.
  • article 32 Citação(ões) na Scopus
    Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a high-protein diet?
    (2013) LUGARESI, Rebeca; LEME, Marco; PAINELLI, Vitor de Salles; MURAI, Igor Hisashi; ROSCHEL, Hamilton; SAPIENZA, Marcelo Tatit; LANCHA JUNIOR, Antonio Herbert; GUALANO, Bruno
    Background: The aim of this study was to determine the effects of creatine supplementation on kidney function in resistance-trained individuals ingesting a high-protein diet. Methods: A randomized, double-blind, placebo-controlled trial was performed. The participants were randomly allocated to receive either creatine (20 g/d for 5 d followed by 5 g/d throughout the trial) or placebo for 12 weeks. All of the participants were engaged in resistance training and consumed a high-protein diet (i.e., >= 1.2 g/Kg/d). Subjects were assessed at baseline (Pre) and after 12 weeks (Post). Glomerular filtration rate was measured by Cr-51-EDTA clearance. Additionally, blood samples and a 24-h urine collection were obtained for other kidney function assessments. Results: No significant differences were observed for Cr-51-EDTA clearance throughout the trial (Creatine: Pre 101.42 +/- 13.11, Post 108.78 +/- 14.41 mL/min/1.73m(2); Placebo: Pre 103.29 +/- 17.64, Post 106.68 +/- 16.05 mL/min/1.73m(2); group x time interaction: F = 0.21, p = 0.64). Creatinine clearance, serum and urinary urea, electrolytes, proteinuria, and albuminuria remained virtually unchanged. Conclusions: A 12-week creatine supplementation protocol did not affect kidney function in resistance-trained healthy individuals consuming a high-protein diet; thus reinforcing the safety of this dietary supplement.
  • article 0 Citação(ões) na Scopus
    Influence on voxel-based dosimetry: noise effect on absorbed dose dosimetry at single time-point versus sequential single-photon emission computed tomography
    (2023) FONDA, Uysha de S.; LEITAO, Andre L. A.; PAIVA, Marcia M. D. P.; WILLEGAIGNON, Jose; JOSEFSSON, Anders; BUCHPIGUEL, Carlos A.; SAPIENZA, Marcelo T.
    ObjectiveThe purpose of this study was to evaluate how statistical fluctuation in single-photon emission computed tomography (SPECT) images propagate to absorbed dose maps. MethodsSPECT/computed tomography (CT) images of iodine-131 filled phantoms, using different acquisition and processing protocols, were evaluated using STRATOS software to assess the absorbed dose distribution at the voxel level. Absorbed dose values and coefficient of variation (COV) were analyzed for dosimetry based on single time-point SPECT images and time-integrated activities of SPECT sequences with low and high counts. ResultsConsidering dosimetry based on a single time-point, the mean absorbed dose was not significantly affected by total counts or reconstruction parameters, but the uniformity of the absorbed dose maps had an almost linear correlation with SPECT noise. When high- and low-count SPECT sequences were used to generate an absorbed dose map, the absorbed dose COV for each of the temporal sequences was slightly lower than the absorbed dose COV based on the single SPECT image with the highest count included in the sequence. ConclusionThe impact of changes in SPECT counts and reconstruction parameters is almost linear when dosimetry is based on isolated SPECT images, but less pronounced when dosimetry is based on sequential SPECTs.
  • article 7 Citação(ões) na Scopus
    Ga-68-PSMA-11 PET/MRI versus multiparametric MRI in men referred for prostate biopsy: primary tumour localization and interreader agreement
    (2022) FERRARO, Daniela A.; HOETKER, Andreas M.; BECKER, Anton S.; MEBERT, Iliana; LAUDICELLA, Riccardo; BALTENSPERGER, Anka; RUPP, Niels J.; RUESCHOFF, Jan H.; MUELLER, Julian; MORTEZAVI, Ashkan; SAPIENZA, Marcelo T.; EBERLI, Daniel; DONATI, Olivio F.; BURGER, Irene A.
    Background Magnetic resonance imaging (MRI) is recommended by the European Urology Association guidelines as the standard modality for imaging-guided biopsy. Recently positron emission tomography with prostate-specific membrane antigen (PSMA PET) has shown promising results as a tool for this purpose. The aim of this study was to compare the accuracy of positron emission tomography with prostate-specific membrane antigen/magnetic resonance imaging (PET/MRI) using the gallium-labeled prostate-specific membrane antigen (Ga-68-PSMA-11) and multiparametric MRI (mpMRI) for pre-biopsy tumour localization and interreader agreement for visual and semiquantitative analysis. Semiquantitative parameters included apparent diffusion coefficient (ADC) and maximum lesion diameter for mpMRI and standardized uptake value (SUVmax) and PSMA-positive volume (PSMA(vol)) for PSMA PET/MRI. Results Sensitivity and specificity were 61.4% and 92.9% for mpMRI and 66.7% and 92.9% for PSMA PET/MRI for reader one, respectively. RPE was available in 23 patients and 41 of 47 quadrants with discrepant findings. Based on RPE results, the specificity for both imaging modalities increased to 98% and 99%, and the sensitivity improved to 63.9% and 72.1% for mpMRI and PSMA PET/MRI, respectively. Both modalities yielded a substantial interreader agreement for primary tumour localization (mpMRI kappa = 0.65 (0.52-0.79), PSMA PET/MRI kappa = 0.73 (0.61-0.84)). ICC for SUVmax, PSMA(vol) and lesion diameter were almost perfect (>= 0.90) while for ADC it was only moderate (ICC = 0.54 (0.04-0.78)). ADC and lesion diameter did not correlate significantly with Gleason score (rho = 0.26 and rho = 0.16) while SUVmax and PSMA(vol) did (rho = - 0.474 and rho = - 0.468). Conclusions PSMA PET/MRI has similar accuracy and reliability to mpMRI regarding primary prostate cancer (PCa) localization. In our cohort, semiquantitative parameters from PSMA PET/MRI correlated with tumour grade and were more reliable than the ones from mpMRI.
  • article 7 Citação(ões) na Scopus
    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 Alberto
    Herein, 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.
  • article 1 Citação(ões) na Scopus
    Potential of [C-11](R)-PK11195 PET Imaging for Evaluating Tumor Inflammation: A Murine Mammary Tumor Model
    (2022) SOUZA, Aline Morais de; REAL, Caroline Cristiano; JUNQUEIRA, Mara de Souza; SOUZA, Larissa Estessi de; MARQUES, Fabio Luiz Navarro; BUCHPIGUEL, Carlos Alberto; CHAMMAS, Roger; SAPIENZA, Marcelo Tatit; FARIA, Daniele de Paula
    Background: Breast tumor inflammation is an immunological process that occurs mainly by mediation of Tumor-Associated Macrophages (TAM). Aiming for a specific measurement of tumor inflammation, the current study evaluated the potential of Positron Emission Tomography (PET) imaging with [C-11](R)-PK11195 to evaluate tumor inflammation in a mammary tumor animal model. Methods: Female Balb/C mice were inoculated with 4T1 cells. The PET imaging with [C-11](R)-PK11195 and [F-18]FDG was acquired 3 days, 1 week, and 2 weeks after cell inoculation. Results: The [C-11](R)-PK11195 tumor uptake increased from 3 days to 1 week, and decreased at 2 weeks after cell inoculation, as opposed to the [F-18]FDG uptake, which showed a slight decrease in uptake at 1 week and increased uptake at 2 weeks. In the control group, no significant differences occurred in tracer uptake over time. Tumor uptake of both radiopharmaceuticals is more expressed in tumor edge regions, with greater intensity at 2 weeks, as demonstrated by [C-11](R)-PK11195 autoradiography and immunofluorescence with TSPO antibodies and CD86 pro-inflammatory phenotype. Conclusion: The [C-11](R)-PK11195 was able to identify heterogeneous tumor inflammation in a murine model of breast cancer and the uptake varied according to tumor size. Together with the glycolytic marker [F-18]FDG, molecular imaging with [C-11](R)-PK11195 may provide a better characterization of inflammatory responses in cancer.