GEORGE BARBERIO COURA FILHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- 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.
- A prospective cross-sectional study estimated glomerular filtration rate from creatinine and cystatin C in adults with solid tumors(2022) SILVA, Veronica T. Costa e; JR, Luiz A. Gil; INKER, Lesley A.; CAIRES, Renato A.; COSTALONGA, Elerson; COURA-FILHO, George; SAPIENZA, Marcelo T.; JR, Gilberto Castro; ESTEVEZ-DIZ, Maria Dp; ZANETTA, Dirce Maria T.; ANTONANGELO, Leila; MARCAL, Lia; TIGHIOUART, Hocine; MIAO, Shiyuan; MATHEW, Paul; LEVEY, Andrew S.; BURDMANN, Emmanuel A.Current guidelines recommend estimating glomerular filtration rate (eGFR) using creatinine (eGFRcr) with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation as the first test for GFR evaluation, but the Cockcroft-Gault (CG) equation is still commonly used in oncology practice and clinical trials despite increasing evidence of its inaccuracy compared to measured GFR (mGFR). Guidelines recommend eGFR using cystatin C (eGFRcys) or both markers (eGFRcr-cys) as a confirmatory test, but neither was carefully evaluated in cancer patients. Therefore, we compared performance of the CKD-EPI equations and others to the CG equation in adults with a variety of solid tumors. The mGFR was determined by plasma clearance of Cr-51-EDTA. Bias was defined as the median of the differences between mGFR and eGFR while accuracy was defined as the percentage of estimates that differed by more than 30% from the measured GFR (1-P30). We prospectively recruited 1,200 patients between April 2015 and September 2017 with a mean age and mGFR of 58.8 years and 78.4 ml/min/1.73m 2 , respectively. Bias among eGFRcr equations varied from -8.1 to +6.1 ml/min/1.73 m(2). CG was the least accurate, 1-P30 (95% confidence interval) was 24.9 (22.4- 27.3)%; CKD-EPI had 1-P30 of 19.1 (16.8-21.2)% while eGFRcr-cys had the best performance: bias -2.0 (-2.6 to -1.1) ml/min/1.73m(2) and 1-P30 7.8 (6.3-9.4)%. Thus, the CG equation should not be preferred over CKD-EPI equation, and eGFRcr-cys can be used as a confirmatory test in adults with solid tumors. Hence, a major policy implication would be to adopt general practice guideline-recommended methods for GFR evaluation in oncology practice and clinical trials.
- Is there a role for diagnostic scans in the management of intermediate-risk thyroid cancer?(2022) DANILOVIC, Debora L. S.; COURA-FILHO, George B.; RECCHIA, Giulianna M.; CASTRONEVES, Luciana A.; MARUI, Suemi; BUCHPIGUEL, Carlos A.; HOFF, Ana O.; KOPP, PeterRadioiodine (RAI) is selectively recommended for intermediate-risk differentiated thyroid carcinomas (DTC). The information gleaned from pretherapy stimulated thyroglobulin levels (sTg) and diagnostic I-131 whole-body scans (DxWBS) to guide therapy remains controversial. The present study aimed at evaluating the impact of preablation sTg and DxWBS in the management of intermediate-risk DTC. A retrospective analysis of 301 intermediate-risk DTC patients submitted to total thyroidectomy and RAI therapy was performed. Pretherapy sTg and DxWBS and post-therapy WBS (RxWBS) findings were analyzed and compared to outcomes. Fifty-two patients (17.3%) had metastases diagnosed by DxWBS and/or RxWBS. The DxWBS identified 10.6% of patients with functioning metastases, including unexpected distant metastases. If combined with SPECT-CT, DxWBS detected RAI-avid metastases more frequently, particularly lymph node metastases (13.1% vs 4.2% planar WBS, P = 0.015). The DxWBS findings modified patient management in 8.3%. A pretherapy sTg <1 ng/mL was associated with a low false-negative rate for the presence of metastases (5.2%), and its performance in excluding metastasis was improved by a negative DxWBS (2.7% of patients with both negative exams had metastases in RxWBS). A sTg <1 ng/mL predicted statistically significant lower rates of recurrent/persistent disease and biochemical/structural incomplete responses. In conclusion, preablation sTg and DxWBS contribute to the detection of unknown or persistent metastatic disease in intermediate-risk DTC patients. A sTg <1 ng/mL in combination with a negative DxWBS is highly suggestive of the absence of remaining malignant disease, and one may consider deferring RAI ablation if both exams are negative. A stunning effect is rarely observed and it does not impair proper treatment of metastases.
- A Prospective Cross-Sectional Study on the Performance of the 2021 CKD-EPI Equations Without Race in a Multiracial Population of Adults With Solid Tumors in Brazil(2023) SILVA, Veronica T. Costa e; JR, Luiz A. Gil; INKER, Lesley A.; CAIRES, Renato A.; COSTALONGA, Elerson; COURA-FILHO, George; SAPIENZA, Marcelo T.; JR, Gilberto Castro; ESTEVEZ-DIZ, Maria D. P.; ZANETTA, Dirce Maria T.; ANTONANGELO, Leila; MARCAL, Lia; TIGHIOUART, Hocine; MIAO, Shiyuan; MATHEW, Paul; LEVEY, Andrew S.; BURDMANN, Emmanuel A.
conferenceObject Predicting dosimetry for therapy using imaging analogs of therapeutic radiopharmaceuticals: An uncertainty and sensitivity analysis applicable to Theranostics(2015) JOSEFSSON, Anders; HOBBS, Robert; PLYKU, Donika; HUANG, Kevin; WILLEGAIGNON, Jose; COURA FILHO, George; DUARTE, Paulo; SAPIENZA, Marcelo; SGOUROS, George