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
8 resultados
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- 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.
- 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.
- 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.
- Brain Metastasis of Medullary Thyroid Carcinoma Without Macroscopic Calcification Detected First on 68Ga-Dotatate and Then on 18F-Fluoride PET/CT(2018) DUARTE, Paulo Schiavom; MARIN, Jose Flavio Gomes; CARVALHO, Jose Willegaignon De Amorim De; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoWe report a case of a medullary thyroid carcinoma noncalcified brain metastasis characterized on Ga-68-dotatate PET/CT but not on an F-18-fluoride PET/CT performed 1 month later. Subsequent F-18-fluoride PET/CT studies performed 7 and 19 months after the Ga-68-dotatate PET/CT study demonstrated focal uptake in the metastasis. The CT images of the last PET/CT study also depicted a small focus of calcification beginning in the metastatic site.
- Accuracy in dosimetry of diagnostic agents: impact of the number of source tissues used in whole organ S value-based calculations(2020) JOSEFSSON, Anders; SIRITANTIKORN, Klaikangwol; RANKA, Sagar; CARVALHO, Jose Willegaignon de Amorim de; BUCHPIGUEL, Carlos Alberto; SAPIENZA, Marcelo Tatit; BOLCH, Wesley E.; SGOUROS, GeorgeBackground Dosimetry for diagnostic agents is performed to assess the risk of radiation detriment (e.g., cancer) associated with the imaging agent and the risk is assessed by computing the effective dose coefficient, e. Stylized phantoms created by the MIRD Committee and updated by work performed by Cristy-Eckerman (CE) have been the standard in diagnostic dosimetry. Recently, the ICRP developed voxelized phantoms, which are described in ICRP Publication 110. These voxelized phantoms are more realistic and detailed in describing human anatomy compared with the CE stylized phantoms. Ideally, all tissues should be represented and their pharmacokinetics collected for an as accurate a dosimetric calculation as possible. As the number of source tissues included increases, the calculated e becomes more accurate. There is, however, a trade-off between the number of source tissues considered, and the time and effort required to measure the time-activity curve for each tissue needed for the calculations. In this study, we used a previously published Ga-68-DOTA-TATE data set to examine how the number of source tissues included for both the ICRP voxelized and CE stylized phantoms affected e. Results Depending upon the number of source tissues included e varied between 14.0-23.5 mu Sv/MBq for the ICRP voxelized and 12.4-27.7 mu Sv/MBq for the CE stylized phantoms. Furthermore, stability in e, defined as a < 10% difference between e obtained using all source tissues compared to one using fewer source tissues, was obtained after including 5 (36%) of the 14 source tissues for the ICRP voxelized, and after including 3 (25%) of the 12 source tissues for the CE stylized phantoms. In addition, a 2-fold increase in e was obtained when all source tissues where included in the calculation compared to when the TIAC distribution was lumped into a single reminder-of-body source term. Conclusions This study shows the importance of including the larger tissues like the muscles and remainder-of-body in the dosimetric calculations. The range of e based on the included tissues were less for the ICRP voxelized phantoms using tissue weighting factors from ICRP Publication 103 compared to CE stylized phantoms using tissue weighting factors from ICRP Publication 60.
- Comparison of(18)F-NaF PET/CT with Other Imaging Methods in the Detection of Bone Metastases in Patients with Medullary Thyroid Cancer: a Report of a Series of 31 Cases(2020) UEDA, Cristina Emiko; DUARTE, Paulo Schiavom; CASTRONEVES, Luciana Audi de; COURA-FILHO, George Barberio; SADO, Heitor Naoki; SAPIENZA, Marcelo Tatit; HOFF, Ana Oliveira; BUCHPIGUEL, Carlos AlbertoPurpose To compare the(18)F-NaF PET/CT studies (F-18-NaF) with other imaging methods in the detection of skeletal metastases (SM) in patients with medullary thyroid cancer (MTC). Methods We retrospectively analyzed 31 patients with MTC who performed(18)F-NaF to assess SM. The results of the(18)F-NaF were compared with other imaging methods performed for metastasis detection:Tc-99-MDP bone scan (BS), magnetic resonance imaging (MRI), contrast-enhanced CT (CT), and(68)Ga-Dotatate and(18)F-FDG PET/CT studies. A qualitative analysis comparing the(18)F-NaF findings with the ones of the other methods was performed, and the results were classified as superior (>), equal (=), and inferior (Results Eleven patients had no bone metastases detected on any of the imaging methods used. Twenty patients presented SM depicted on(18)F-NaF. Of these 20 patients, 12 performed bone scan (in 9(18)F-NaF > BS and in 3(18)F-NaF = BS), 1 performed(18)F-FDG (F-18-NaF > F-18-FDG), 4 performed(68)Ga-Dotatate (in 2(18)F-NaF > Ga-68-Dotatate and in 2(18)F-NaF = Ga-68-Dotatate), 20 performed CT of at least one body segment (in 15(18)F-NaF = CT and in 5(18)F-NaF > CT), and 16 performed MRI of at least one body segment, and in all of them, the(18)F-NaF was equal to the MRI. Beside this, the(18)F-NaF detected SM in body segments not routinely scanned in MRI and CT. Conclusion In patients with MTC, the(18)F-NaF seems to be equal or superior to other imaging modalities in the detection of SM and allows the analysis of the whole skeletal in a single study.
- Visualization of Lymph Nodal and Hepatic Metastases of Medullary Thyroid Carcinoma on F-18-Fluoride PET/CT(2015) VALE, Romulo Hermeto Bueno do; MARIN, Jose Flavio Gomes; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoF-18-fluoride uptake in soft tissue metastases has been previously described. Herein, we report a case of F-18-fluoride uptake in lymph nodal and hepatic metastases of medullary thyroid carcinoma. Simultaneous CT showed calcified lesions in these regions.
- 18F-Fluoride Uptake in Soft Tissue Metastases of Medullary Thyroid Carcinoma as a Marker of Progressive Calcification(2018) DUARTE, Paulo Schiavom; MARIN, Jose Flavio Gomes; COURA FILHO, George Barberio; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoF-18-fluoride (F-18-NaF) uptake in soft tissue metastases of medullary thyroid carcinoma (MTC) has been reported. However, the evolution of these metastatic sites has rarely been assessed. We present a case of F-18-NaF uptake in multiple liver metastases of MTC initially without macroscopic calcification. The CT follow-up studies showed a progressive calcium deposition in the lesions. Therefore, this case suggests that the F-18-NaF uptake in MTC metastases could potentially be a marker of an ongoing calcification process instead of an inert deposit of calcium.