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
13 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.
- Ga-68-DOTATATE PET: temporal variation of maximum standardized uptake value in normal tissues and neuroendocrine tumours(2019) COURA-FILHO, George Barberio; HOFF, Ana A. F. O.; DUARTE, Paulo S.; BUCHPIGUEL, Carlos A.; JOSEFSSON, Anders; HOBBS, Robert F.; SGOUROS, George; SAPIENZA, Marcelo T.Objectives Higher affinity of Ga-68 compounds to somatostatin receptors (SSTRs) and PET better image resolution increased interest in Ga-68-labelled somatostatin analogs in the management of neuroendocrine tumours (NETs). This study aimed to evaluate the maximum standardized uptake value (SUVmax) variation in sequential somatostatin analogs-PET in NET patients and identify optimal tumour detection and characterization imaging time. Methods Patients with histological or biochemical NET diagnosis performed two to three PET/computed tomography (CT) scans after intravenous injection of Ga-68-DOTATATE: Early PET [EarlyPET: <15 minutes postinjection (p.i.)], diagnostic PET (DiagPET: 45-90 minutes p.i.) and delayed PET (DelayPE: 90-240 minutes p.i.). Up to five tumour sites and normal tissues had SUVmax determined. Time-SUVmax curves were created for the target lesions and normal organs. Ratios between tumour and liver SUVmax (SUVTU/Liver) and tumour/blood pool (SUVTU/BP) were also calculated. Results Twenty-nine patients were included, 16 female, mean age of 46.5 +/- 14.3 years. Average administered activity was 129.5 +/- 29.6 MBq. Kidneys SUVmax was higher in EarlyPET compared with DiagPET (P = 0.04) and DelayPET showed higher SUVmax compared with DiagPET for normal liver, pancreas and kidneys (P = 0.02). No differences were noted between EarlyPET, DiagPET and DelayPET in tumour SUVmax (P > 0.05). SUVTU/Liver and SUVTU/BP did not change between EarlyPET and DiagPET, with a slight decrease in DelayPET. Conclusion Stability in tumour SUVmax values measured at different intervals independently of tumour location, as also in normal tissues as kidneys and liver suggest that a more flexible imaging protocol may be adopted.
- 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.
- 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.
- 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.