GIOVANNI GUIDO CERRI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Organization of the cancer network in SUS: evolution of the care model(2018) MADI, Marisa Riscalla; CERRI, Giovanni GuidoIn the current context of epidemiological transition, demographic changes, changes in consumption and lifestyle habits, and pressure on care costs and organized health systems for acute conditions, the Integrated Care Model by Shortell has become a conceptual reference in the search for new methods to manage chronic conditions by focusing on the health conditions of a given population that must be addressed by a set of institutions organized into networks. Within the last 15 years, cancer has gone from the third- to the second-leading cause of death in the State of Sao Paulo and has shown a gradual increase in the number of new cases; it has thus become a relevant issue for public health and health management. The model adopted by the State for the organization of the cancer care network was the motivation for this study, which aimed to evaluate the evolution of the model of care for cancer patients within the Unified Health System (Sistema Unico de Saude) based on the integrated care model. Since 1993, the year that cancer was first considered highly complex in the Sistema Unico de Saude by the Ministry of Health, it has been possible to observe a progressive orientation towards the integral and integrated care of patients with cancer. In the State of Sao Paulo, the active participation of qualified service providers through a Technical Reference Committee showed that experts could contribute to the definition of public policies, thereby providing a technical base for decision making and contributing to the development of clinical management.
- Positron emission tomography/magnetic resonance imaging (PET/MRI): An update and initial experience at HC-FMUSP(2018) QUEIROZ, Marcelo A.; BARBOSA, Felipe de Galiza; BUCHPIGUEL, Carlos Alberto; CERRI, Giovanni GuidoThe new technology of PET/MRI is a prototype of hybrid imaging, allowing for the combination of molecular data from PET scanning and morphofunctional information derived from MRI scanning. Recent advances regarding the technical aspects of this device, especially after the development of MRI-compatible silicon photomultipliers of PET, permitted an increase in the diagnostic performance of PET/MRI translated into dose reduction and higher imaging quality. Among several clinical applications, PET/MRI gains ground initially in oncology, where MRI per se plays an essential role in the assessment of primary tumors (which is limited in the case of PET/CT), including prostate, rectal and gynecological tumors. On the other hand, the evaluation of the lungs remains an enigma although new MRI sequences are being designed to overcome this. More clinical indications of PET/MRI are seen in the fields of neurology, cardiology and inflammatory processes, and the use of PET/MRI also opens perspectives for pediatric populations as it involves very low radiation exposure. Our review aimed to highlight the current indications of PET/MRI and discuss the challenges and perspectives of PET/MRI at HC-FMUSP.
- Ovarian cancer staging: What the surgeon needs to know(2021) OLIVEIRA, Lucas Roberto Lelis Botelho de; HORVAT, Natally; ANDRIEU, Pamela Ines Causa; PANIZZA, Pedro Sergio Brito; CERRI, Giovanni Guido; VIANA, Publio Cesar CavalcanteOvarian cancer (OC) is the leading cause of gynecological cancer death, and most cases sire diagnosed at advanced stages due to a nonspecific and insidious clinical presentation. Radiologists play a critical role in the decision of which patients are candidates for primary debulking surgery and who may benefit from neoadjuvant chemotherapy. This pictorial review summarizes the dissemination patterns of OC, main imaging findings of metastatic disease, and which findings may alter the treatment plan or predict suboptimal tumor resection.
- Clinical perspectives of PSMA PET/MRI for prostate cancer(2018) BARBOSA, Felipe de Galiza; QUEIROZ, Marcelo Araujo; NUNES, Rafael Fernandes; MARIN, Jose Flavio Gomes; BUCHPIGUEL, Carlos Alberto; CERRI, Giovanni GuidoProstate cancer imaging has become an important diagnostic modality for tumor evaluation. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has been extensively studied, and the results are robust and promising. The advent of the PET/magnetic resonance imaging (MRI) has added morphofunctional information from the standard of reference MRI to highly accurate molecular information from PET. Different PSMA ligands have been used for this purpose including (68)gallium and (18)fluorine-labeled PET probes, which have particular features including spatial resolution, imaging quality and tracer biodistribution. The use of PSMA PET imaging is well established for evaluating biochemical recurrence, even at low prostate-specific antigen (PSA) levels, but has also shown interesting applications for tumor detection, primary staging, assessment of therapeutic responses and treatment planning. This review will outline the potential role of PSMA PET/MRI for the clinical assessment of PCa.
- Whole-Body Magnetic Resonance Imaging in the Oncology Setting: An Overview and Update on Recent Advances(2019) BEZERRA, Regis Otaviano Franca; RECCHIMUZZI, Debora Zachello; MOTA, Micaela Maciel dos Santos; GARCIA, Marcio Ricardo Taveira; MENEZES, Marcos Roberto de; MAZO, Paulo Eduardo; CERRI, Giovanni GuidoWhole-body magnetic resonance imaging is becoming an important tool in oncology as a nonirradiating imaging technique since recent technological advances allowed the incorporation of high-quality imaging in an adequate time. Moreover, the noninjection of radioisotope/intravenous contrast, low cost compared with traditional nuclear medicine techniques, and fast acquisition times are another distinct feature. Thus, the purpose of this article is to review the whole-body magnetic resonance imaging protocol and its main applications in the oncology setting.
- Anatomical Variants in Prostate Artery Embolization: A Pictorial Essay(2017) CARNEVALE, Francisco Cesar; SOARES, Guilherme Rebello; ASSIS, Andre Moreira de; MOREIRA, Airton Mota; HARWARD, Sardis Honoria; CERRI, Giovanni GuidoProstate artery embolization (PAE) has emerged as a new treatment option for patients with symptomatic benign prostatic hyperplasia. The main challenges related to this procedure are navigating arteries with atherosclerosis and anatomical variations, and the potential risk of non-target embolization to pelvic structures due to the presence of collateral shunts and reflux of microparticles. Knowledge of classical vascular anatomy and the most common variations is essential for safe embolization, good clinical practice, and optimal outcomes. The aim of this pictorial essay is to illustrate the pelvic vascular anatomy relevant to PAE in order to provide a practical guide that includes the most common anatomical variants as well as to discuss the technical details related to each.
- Cardiovascular Imaging and Interventional Procedures in Patients with Novel Coronavirus Infection(2020) COSTA, Isabela Bispo Santos da Silva; ROCHITTE, Carlos Eduardo; CAMPOS, Carlos M.; BARBERATO, Silvio Henrique; OLIVEIRA, Glaucia Maria Moraes de; LOPES, Marcelo Antonio Cartaxo Queiroga; NOMURA, Cesar Higa; ABIZAID, Alexandre A.; CERRI, Giovanni; KALIL FILHO, Roberto; HAJJAR, Ludhmila AbrahaoThe coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.
- Audiovisual Sexual Stimulation Improves Diagnostic Accuracy of Penile Doppler Ultrasound in Patients With Erectile Dysfunction(2020) CARNEIRO, Felipe; NASCIMENTO, Bruno; MIRANDA, Eduardo P.; CURY, Jose; CERRI, Giovanni G.; CHAMMAS, Maria CristinaIntroduction: Although penile Doppler ultrasound (PDU) is a useful tool in evaluating erectile dysfunction (ED), an optimal erectile response might be limited because of an increased sympathetic discharge. Audiovisual sexual stimulation (AVSS) has been suggested to help improving PDU performance. Aim: To evaluate the use of AVSS as a tool to improve diagnostic accuracy of PDU studies. Methods: A total of 40 men (mean age: 61.8 +/- 10.2 years) with ED were enrolled. PDU sessions were performed in a randomized fashion as follows: session A under intracavernous injection (ICI) alone and session B under ICI and AVSS with 7-day interval between sessions. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured 5, 10, 15, and 20 minutes after ICI. Main Outcome Measure: Comparisons between PSV, EDV, and RI values were performed with and without AVSS. Univariable and multivariable analyses including clinical and demographic parameters were performed to evaluate predictors of an abnormal PDU. Results: 23 patients performed the first session without AVSS, and 17 performed the first session with AVSS. EDV and RI were better in AVSS session (p = 0.022 and 0.019). PSV was not influenced by AVSS (p = 0.768). The proportion of patients whose diagnosis was changed because of the AVSS was 4 of 40 (10.0%, 95% confidence interval [CI]: 2.8-23.7%). Of 12 patients with venous leak observed on the PDU without AVSS, 3 turned into normal after AVSS (25.0%, 95% CI: 5.5-57.2%). Of 4 men with arterial insufficiency observed on the PDU on ICI alone, 1 became normal after AVSS (25.0%, 95% CI: 0.6-80.6%). International Index of Erectile Function-5 scores were lower in patients with abnormal PDU (6.3 +/- 3.3 vs 12.0 +/- 5.8, p=0.003). On multivariable analysis, DM and International Index of Erectile Function-5 scores were the only independent predictors of abnormal PDU studies. Clinical Implications: False diagnoses of venous leak during PDU with ICI could be a result of an increased adrenergic discharge during the examination. Routine AVSS may be helpful to avoid error in diagnosis. Strength & Limitations: The study has randomized the use of AVSS in different session orders. Only one previously published study has used this strategy to control the accommodation effect in repeat studies, a common source of bias in the PDU literature. The main limitation is the absence of a rigidity assessment and a redosing protocol. Conclusion: Adding AVSS during PDU improves ICI response and may help clinicians evaluate penile hemodynamics more accurately.
- A Review of Adverse Events Related to Prostatic Artery Embolization for Treatment of Bladder Outlet Obstruction Due to BPH(2017) MOREIRA, Airton Mota; ASSIS, Andre Moreira de; CARNEVALE, Francisco Cesar; ANTUNES, Alberto Azoubel; SROUGI, Miguel; CERRI, Giovanni GuidoMinimally invasive procedures have gained great importance among the treatments for benign prostate hyperplasia (BPH) due to their low morbidity. Prostate artery embolization has emerged as a safe and effective alternative for patients with large volume BPH, not suited for surgery. Low adverse events rates have been reported following prostate artery embolization and may include dysuria, urinary infection, hematuria, hematospermia, acute urinary retention and rectal bleeding. Although most complaints are reported as side effects, complications can also be superimposed. The prostate gland is the most common source of complaints following PAE, where the inflammatory process can create a large variety of localized symptoms. Periprostatic organs and structures such as bladder, rectum, penis, seminal vesicle, pelvis, bones and skin may be damaged by nontarget embolization, especially due to the misidentification of the normal vascular anatomy and variants or due to inadvertent embolic reflux. Radiodermatitis may also happen in case of small vessel size, atherosclerosis, the learning curve and long procedure or fluoroscopy times. Regarding safety, it is pivotal to understand the pathophysiology of adverse events following PAE and their standardized reporting. The aim of this article is to discuss adverse events, their management and to review the current literature.
- Imaging findings in COVID-19 pneumonia(2020) FARIAS, Lucas de Padua Gomes de; FONSECA, Eduardo Kaiser Ururahy Nunes; STRABELLI, Daniel Giunchetti; LOUREIRO, Bruna Melo Coelho; NEVES, Yuri Costa Sarno; RODRIGUES, Thiago Potrich; CHATE, Rodrigo Caruso; NOMURA, Cesar Higa; SAWAMURA, Marcio Valente Yamada; CERRI, Giovanni GuidoThe coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan city and was declared a pandemic in March 2020. Although the virus is not restricted to the lung parenchyma, the use of chest imaging in COVID-19 can be especially useful for patients with moderate to severe symptoms or comorbidities. This article aimed to demonstrate the chest imaging findings of COVID-19 on different modalities: chest radiography, computed tomography, and ultrasonography. In addition, it intended to review recommendations on imaging assessment of COVID-19 and to discuss the use of a structured chest computed tomography report. Chest radiography, despite being a low-cost and easily available method, has low sensitivity for screening patients. It can be useful in monitoring hospitalized patients, especially for the evaluation of complications such as pneumothorax and pleural effusion. Chest computed tomography, despite being highly sensitive, has a low specificity, and hence cannot replace the reference diagnostic test (reverse transcription polymerase chain reaction). To facilitate the confection and reduce the variability of radiological reports, some standardizations with structured reports have been proposed. Among the available classifications, it is possible to divide the radiological findings into typical, indeterminate, atypical, and negative findings. The structured report can also contain an estimate of the extent of lung involvement (e.g., more or less than 50% of the lung parenchyma). Pulmonary ultrasonography can also be an auxiliary method, especially for monitoring hospitalized patients in intensive care units, where transfer to a tomography scanner is difficult.