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
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- Color Duplex Doppler US can Follow up the Response of Radioiodine in Graves' Disease by Evaluating the Thyroid Volume and Peak Systolic Velocity(2020) SANTOS, Thiago Adler Ralho Rodrigues; MARUI, Suemi; WATANABE, Tomoco; LIMA, Nicolau; OZAKI, Claudia Okanobo; CERRI, Giovanni Guido; CHAMMAS, Maria C.Purpose The objective of this study was to prove the efficacy of Doppler ultrasonography (US-Doppler) in the follow-up of patients with GD treated with radioactive iodine. Methods 97 patients (77 female and 20 male) with a mean age of 42 years (SD +/- 15) and with prior diagnosis of GD were treated with radioiodine. In total, 88.5 % achieved euthyroidism or hypothyroidism after treatment. The study was documented before treatment and one, three, and six months after treatment with radioactive iodine (131I) by a single investigator. The volume, echogenicity, echotexture and vascularization of the glands as well as the peak systolic velocity (PSV) of the inferior thyroid arteries were evaluated and compared with the laboratory data. Results Thyroid volume and PSV had a statistically significant correlation with hormone levels (p < 0.05). The mean pre-dose therapeutic thyroid volume was 43.01 +/- 3.88 cm(3) and was 11.58 +/- 11.26 cm(3) 6 months after treatment. The mean PSV before 131I was 90.06 +/- 44.13 cm/s and decreased significantly over time (p < 0.001). Six months after the therapeutic dose, the mean PSV was 32.95 +/- 16.36 cm/s. However, the subjective parameters did not have a significant correlation with the normalization of the thyroid hormones. Conclusion Doppler US was useful for monitoring the therapeutic response of GD patients after treatment with radioiodine by evaluating the thyroid volume and peak systolic velocity.
- Influence of patent ductus arteriosus on left ventricular myocardial deformation in preterm neonates in the early neonatal period(2020) ALMEIDA, Kellen Freitas Silva de; LEAL, Gabriela Nunes; MORHY, Samira Saady; RODRIGUES, Ana Clara Tude; CERRI, Giovanni G.; DORIA-FILHO, Ulysses; ANDRADE, Jose Lazaro de
- Theranostics in Nuclear Medicine: Emerging and Re-emerging Integrated Imaging and Therapies in the Era of Precision Oncology(2020) MARIN, Jose Flavio Gomes; NUNES, Rafael F.; COUTINHO, Artur M.; ZANIBONI, Elaine C.; COSTA, Larissa B.; BARBOSA, Felipe G.; QUEIROZ, Marcelo A.; CERRI, Giovanni G.; BUCHPIGUEL, Carlos A.Theranostics refers to the pairing of diagnostic biomarkers with therapeutic agents that share a specific target in diseased cells or tissues. Nuclear medicine, particularly with regard to applications in oncology, is currently one of the greatest components of the theranostic concept in clinical and research scenarios. Theranostics in nuclear medicine, or nuclear theranostics, refers to the use of radioactive compounds to image biologic phenomena by means of expression of specific disease targets such as cell surface receptors or membrane transporters, and then to use specifically designed agents to deliver ionizing radiation to the tissues that express these targets. The nuclear theranostic approach has sparked increasing interest and gained importance in parallel to the growth in molecular imaging and personalized medicine, helping to provide customized management for various diseases; improving patient selection, prediction of response and toxicity, and determination of prognosis; and avoiding futile and costly diagnostic examinations and treatment of many diseases. The authors provide an overview of theranostic approaches in nuclear medicine, starting with a review of the main concepts and unique features of nuclear theranostics and aided by a retrospective discussion of the progress of theranostic agents since early applications, with illustrative cases emphasizing the imaging features. Advanced concepts regarding the role of fluorine 18-fluorodeoxyglucose PET in theranostics, as well as developments in and future directions of theranostics, are discussed. (C) RSNA, 2020
bookPart Giovanni Guido Cerri(2020) CERRI, Giovanni Guido- COVID-19 pneumonia: what is the role of imaging in diagnosis?(2020) ARAUJO-FILHO, Jose de Arimateia Batista; SAWAMURA, Marcio Valente Yamada; COSTA, Andre Nathan; CERRI, Giovanni Guido; NOMURA, Cesar Higa
- COVID-19 pneumonia in the emergency department: correlation of initial chest CT findings with short-term outcome(2020) BARBOSA, Camila Silva; CHAVES, Guilherme Wilson Otaviano Garcia; OLIVEIRA, Camila Vilela de; BACHION, Guilherme Hipolito; CHI, Chang Kai; CERRI, Giovanni Guido; LIMA, Thais Carneiro; LEE, Hye JuPurpose Evaluate chest computed tomography (CT) findings of laboratory-confirmed Coronavirus Disease 2019 (COVID-19) cases and correlate it with clinical and laboratorial signs of severe disease and short-term outcome. Methods Chest CTs of 61 consecutive cases of COVID-19 disease that attended in our emergency department (ED) were reviewed. Three groups of patients classified according to the short-term follow-up were compared: (1) early-discharged from ED, (2) hospitalized on regular wards, and (3) admitted to intensive care unit (ICU). CT findings were also correlated with clinical and laboratorial features associated with severe disease. Results Median age was 52 years (IQR 39-63) with male predominance (60.7%). Most of the patients that did not require hospitalization had parenchymal involvement of less than 25% on CT (84.6%). Among hospitalized patients, interlobular septal thickening and extensive lung disease (> 50% of parenchyma) were significantly more frequent in ICU-admitted patients (P = 0.018 andP = 0.043, respectively). Interlobular septal thickening also correlated with longer ICU stay (P = 0.018). Low oxygen saturation (SpO(2) <= 93%) was associated with septal thickening (P = 0.004), diffuse distribution (P = 0.016), and pleural effusion (P = 0.037) on CT. All patients with > 50% of parenchymal involvement showed SpO(2) <= 93%. Elevated C-reactive protein (CRP) levels (> 5.0 mg/dL) correlated with consolidation (P = 0.002), septal thickening (P = 0.018), diffuse distribution (P = 0.020), and more extensive parenchymal involvement (P = 0.017). Conclusion Interlobular septal thickening on CT was associated with ICU admission and longer stay on ICU. Diffuse distribution, septal thickening, and more extensive lung involvement correlated with lower SpO(2)and higher CRP levels. Patients that needed hospitalization and ICU admission presented more extensive lung disease on CT.
- 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.
- 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.
- 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.
- Prostatic Artery Embolization for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: 10 Years' Experience(2020) CARNEVALE, Francisco Cesar; MOREIRA, Airton Mota; ASSIS, Andre Moreira de; ANTUNES, Alberto Azoubel; RODRIGUES, Vanessa Cristina de Paula; SROUGI, Miguel; CERRI, Giovanni GuidoBackground: Long-term experience with prostatic artery embolization (PAE) for benign prostatic hyperplasia remains limited. Purpose: To evaluate the efficacy, safety, and long-term results of PAE for benign prostatic hyperplasia. Materials and Methods: This retrospective single-center study was conducted from June 2008 to June 2018 in patients with moderate-to severe benign prostatic hyperplasia-related symptoms. International Prostate Symptom Score (IPSS), quality-of-life score, maximum urinary flow rate, postvoid residual volume, prostate-specific antigen (PSA), and prostate volume were assessed. PAE was performed with 100-500-mu m embolic microspheres. Mixed-model analysis of variance and Kaplan-Meyer method was accessed, as appropriate. Results: A total of 317 consecutive men (mean age 6 standard deviation, 65 years 6 8) were treated. Follow-up ranged from 3 months to 96 months (mean, 27 months). Bilateral and unilateral PAE was performed in 298 (94%) and 19 (6%) men, respectively. Early clinical failure occurred in six (1.9%) and symptom recurrence in 72 (23%) men at a median follow-up of 72 months. Mean maximum improvement was as follows: IPSS, 16 points +/- 7; quality-of-life score, 4 points +/- 1; prostatic volume reduction, 39 cm(3) +/- 39 (39% +/- 29); maximum urinary flow rate, 6 mL/sec +/- 10 (155% +/- 293); and postvoid residual volume, 70 mL +/- 6121 (48% +/- 81) (P < .05 for all). Unilateral PAE was associated with higher recurrence (42% vs 21%; P =.04). Baseline PSA was inversely related with recurrence (hazard ratio, 0.9 per nanograms per milliliter of PSA; 95% confidence interval [CI], 0.8, 0.9; P < .001). Embolization with combined particle sizes (100-500 mu m) did not relate to symptom recurrence (hazard ratio, 0.4; 95%CI: 0.2, 1.1 for 100-500-mu m group vs 300-500-mu m group and hazard ratio, 0.4; 95% CI: 0.1, 1.5 for 100-500-mu m group vs 100-300-mm group; P =.19). None of the patients presented with urinary incontinence or erectile dysfunction. Conclusion: Prostatic artery embolization was a safe and effective procedure for benign prostatic hyperplasia with good long-term results for lower urinary tract symptoms. (C) RSNA, 2020