CLAUDIA DA COSTA LEITE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
7 resultados
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- Response Assessment in Neuro-Oncology Criteria for Gliomas: Practical Approach Using Conventional and Advanced Techniques(2020) LEAO, D. J.; CRAIG, P. G.; GODOY, L. F.; LEITE, C. C.; POLICENI, B.The Response Assessment in Neuro-Oncology criteria were developed as an objective tool for radiologic assessment of treatment response in high-grade gliomas. Imaging plays a critical role in the management of the patient with glioma, from initial diagnosis to posttreatment follow-up, which can be particularly challenging for radiologists. Interpreting findings after surgery, radiation, and chemotherapy requires profound knowledge about the tumor biology, as well as the peculiar changes expected to ensue as a consequence of each treatment technique. In this article, we discuss the imaging findings associated with tumor progression, tumor response, pseudoprogression, and pseudoresponse according to the Response Assessment in Neuro-Oncology criteria for high-grade and lower-grade gliomas. We describe relevant practical issues when evaluating patients with glioma, such as the need for imaging in the first 48?hours, the radiation therapy planning and isodose curves, the significance of T2/FLAIR hyperintense lesions, the impact of the timing for the evaluation after radiation therapy, and the definition of progressive disease on the histologic specimen. We also illustrate the correlation among the findings on conventional MR imaging with advanced techniques, such as perfusion, diffusion-weighted imaging, spectroscopy, and amino acid PET. Because many of the new lesions represent a mixture of tumor cells and tissue with radiation injury, the radiologist aims to identify the predominant component of the lesion and categorize the findings according to Response Assessment in Neuro-Oncology criteria so that the patient can receive the best treatment.
- Differences in Total Brain Volume between Sexes in a Cognitively Unimpaired Elderly Population(2020) BUCHPIGUEL, Marina; ROSA, Pedro; SQUARZONI, Paula; DURAN, Fabio L. S.; TAMASHIRO-DURAN, Jaqueline H.; LEITE, Claudia C.; LOTUFO, Paulo; SCAZUFCA, Marcia; ALVES, Tania C. T. F.; BUSATTO, Geraldo F.OBJECTIVES: Although a large number of studies have shown brain volumetric differences between men and women, only a few investigations have analyzed brain tissue volumes in representative samples of the general elderly population. We investigated differences in gray matter (GM) volumes, white matter (WM) volumes, and intracranial volumes (ICVs) between the sexes in individuals older than 66 years using structural magnetic resonance imaging (MRI). METHODS: Using FreeSurfer version 5.3, we obtained the ICVs and GM and WM volumes from the MRI datasets of 84 men and 92 women. To correct for interindividual variations in ICV, GM and WM volumes were adjusted with a method using the residuals of a least-square-derived linear regression between raw volumes and ICVs. We then performed an analysis of covariance comparing men and women, including age and years of schooling as confounding factors. RESULTS: Women had a lower socioeconomic status overall and fewer years of schooling than men. The comparison of unadjusted brain volumes showed larger GM and WM volumes in men. After the ICV correction, the adjusted volumes of GM and WM were larger in women. CONCLUSION: After the ICV correction and taking into account differences in socioeconomic status and years of schooling, our results confirm previous findings of proportionally larger GM in women, as well as larger WM volumes. These results in an elderly population indicate that brain volumetric differences between sexes persist throughout the aging process. Additional studies combining MRI and other biomarkers to identify the hormonal and molecular bases influencing such differences are warranted.
conferenceObject Amyloid-beta Deposition, Brain Metabolism and Neuropsychological Profile in Elderly with Subjective Cognitive Decline and SuperAgers(2020) STUDART-NETO, Adalberto; COUTINHO, Artur; CARNEIRO, Camila de Godoi; MORAES, Natalia Cristina; SPERA, Raphael Ribeiro; YASSUDA, Monica Sanches; BRUCKI, Sonia Maria Dozzi; LEITE, Claudia; BUCHPIGUEL, Carlos; NITRINI, Ricardo- Fighting the invisible enemy: providing support and structure to radiology resident during the COVID-19 pandemic(2020) GOMES, Regina Lucia Elia; FARIA, Luisa Leitão de; HOLZMANN, Hernane Ajuz; FUJIWARA, Natalia Kimie de Faria; ANDO, Sabrina de Mello; SAWAMURA, Marcio Valente Yamada; LEITE, Claudia da Costa; CERRI, Giovanni GuidoAbstract The objective of this article is to share the strategy we used in order to restructure the radiology and diagnostic imaging department of a referral institution during the coronavirus disease 2019 pandemic, on the basis of the current recommendations. It is essential to integrate the work of supervisors, preceptors, and residents, maintaining communication and sharing decisions, with mutual support, as well as to determine the best strategy to be adopted in this scenario of uncertainty and constant change, while also ensuring adequate emotional support for all parties.
- Acc neuro-metabolic changes from bipolar depression to euthymia: repeated 1h-mrs measurement as a function of mood state and lithium efficacy(2020) SOEIRO-DE-SOUZA, M.; SCOTTI-MUZZI, E.; FERNANDES, F.; SOUZA, R. De; LEITE, C.; OTADUY, M.; MACHADO-VIEIRA, R.
conferenceObject ACC neuro-metabolic changes from bipolar depression to euthymia: Repeated 1H-MRS measurement as a function of mood state and lithium efficacy(2020) SOEIRO-DE-SOUZA, M.; SCOTTI-MUZZI, E.; FERNANDES, F.; ZANETTI, M. V.; DESOUZA, R.; LEITE, C.; OTADUY, M. C.; MACHADO-VIEIRA, R.- Treatment of Upper Limb Paresis With Repetitive Peripheral Nerve Sensory Stimulation and Motor Training: Study Protocol for a Randomized Controlled Trial(2020) CONFORTO, Adriana B.; MACHADO, Andre G.; MENEZES, Isabella; V, Nathalia H. Ribeiro; LUCCAS, Rafael; PIRES, Danielle S.; LEITE, Claudia Costa; PLOW, Ela B.; COHEN, Leonardo G.Background: Repetitive peripheral nerve sensory stimulation (RPSS) has emerged as a potential adjuvant strategy to motor training in stroke rehabilitation. The aim of this study is to test the hypothesis that 3 h sessions of active RPSS associated with functional electrical stimulation (FES) and task-specific training (TST) distributed three times a week, over 6 weeks, is more beneficial to improve upper limb motor function than sham RPSS in addition to FES and TST, in subjects with moderate to severe hand motor impairments in the chronic phase (>6 months) after stroke. Methods: In this single-center, randomized, placebo controlled, parallel-group, double-blind study we compare the effects of 18 sessions of active and sham RPSS as add-on interventions to FES and task-specific training of the paretic upper limb, in 40 subjects in the chronic phase after ischemic or hemorrhagic stroke, with Fugl-Meyer upper limb scores ranging from 7 to 50 and able to voluntarily activate any active range of wrist extension. The primary outcome measure is the Wolf Motor Function Test (WMFT) after 6 weeks of treatment. The secondary outcomes are the WMFT at 3, 10, and 18 weeks after beginning of treatment, as well as the following outcomes measured at 3, 6, 10, and 18 weeks: Motor Activity Log; active range of motion of wrist extension and flexion; grasp and pinch strength in the paretic and non-paretic sides (the order of testing is randomized within and across subjects); Modified Ashworth Scale; Fugl-Meyer Assessment-Upper Limb in the paretic arm; Barthel Index; Stroke Impact Scale. Discussion: This project represents a major step in developing a rehabilitation strategy with potential to have impact on the treatment of stroke patients with poor motor recovery in developing countries worldwide. The study preliminarily evaluates a straightforward, non-invasive, inexpensive intervention. If feasibility and preliminary efficacy are demonstrated, further investigations of the proposed intervention (underlying mechanisms/ effects in larger numbers of patients) should be performed.