JOSE FLAVIO GOMES MARIN
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- 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.
- Whole-Skeleton SUVmean Measured on F-18-NaF PET/CT Studies as a Prognostic Indicator in Patients with Breast Cancer Metastatic to Bone(2022) MARIN, Jose Flavio Gomes; DUARTE, Paulo Schiavom; ORDONES, Monique Beraldo; SADO, Heitor Naoki; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoIn this work, we assessed the association between the whole-skeleton SUVmean measured on F-18-NaF PET/CT studies and overall survival (OS) in patients with breast cancer metastatic to bone. Methods: We retrospectively analyzed 176 patients with breast cancer and metastatic bone disease who underwent F-18-NaF PET/CT. The outcomes of the patients (dead or alive) were based on the last information available in their files. The SUVmean and SUVmax were measured in a whole-skeleton volume of interest (wsVOI). The wsVOI was based on the CT component of the PET/ CT study using Hounsfield unit thresholds. The wsVOI was then applied to the F-18-NaF PET image. Univariate analyses were performed to assess the association of SUVs with OS. We also analyzed the association between OS and patient age; presence of visceral metastatic disease; histologic subtype; presence of hormone receptors; human epidermal growth factor receptor 2 expression; and creatinine, cancer antigen (CA) 15-3, and alkaline phosphatase levels. The variables statistically significant in the univariate analyses were included in a multivariate Cox regression OS analysis. Results: In the univariate analyses, there were associations between OS and whole-skeleton SUVmean and SUVmax, estrogen receptor status, and CA15-3 and alkaline phosphatase levels. In the multivariate analysis, all variables that were statistically significant in the univariate analyses were associated with OS, with the exception of CA15-3. Conclusion: In patients with breast cancer metastatic to bone, whole-skeleton SUVmean is an independent predictor of OS.
- SUV Normalized by Skeletal Volume on F-18-Fluoride PET/CT Studies(2016) CARVALHO, Giovanna; MARIN, Jose Flavio Gomes; GARCEZ, Alexandre Teles; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoObjective: To propose a technique for SUV normalization on F-18-fluoride PET/CT (F-18-NaF) studies based on skeletal volume and to compare the SUVs normalized by this technique with the ones normalized by body weight. Methods: SUVs were obtained in volumes of interest (VOIs) in proximal diaphyseal regions of the right humerus (HD) and right femur (FD) in 12 selected F-18-NaF studies. The 12 studies presented both regions considered normal by visual examination on PET and CT and were performed in patients presenting body weight below 50 kg (B50) or above 90 kg (A90) (6 patients in each group). The maximum SUVs were calculated in these 2 bone regions in both groups of patients using body weight (SUV BW) and skeletal volume (SUV SV) methodologies. The total skeletal volume for each patient was estimated based on whole skeletal VOIs automatically defined on the CT component of the PET/CT study. The maximum SUVs calculated using the 2 methodologies were compared. Results: The maximum SUVs BW were statistically higher in the group A90 in both regions, with a P < 0.001 and P < 0.008 for FD and HD, respectively. The maximum SUVs SV in the 2 regions were not statistically different between the groups B50 and A90, P values of 0.27 and 0.87 for FD and HD, respectively. Conclusions: The SUVs normalized by skeletal volume present similar results in groups of patients with extremes of body weight. Therefore, this methodology could be more adequate than the one normalized by body weight to semiquantitatively analyze F-18-NaF studies.
- 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.
- Comparison of the Variability of SUV Normalized by Skeletal Volume with the Variability of SUV Normalized by Body Weight in F-18-Fluoride PET/CT(2019) MARIN, Jose Flavio Gomes; DUARTE, Paulo Schiavom; CARVALHO, Jose Willegaignon de Amorim de; SADO, Heitor Naoki; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoOur objective was to test the hypothesis that variability in SUV normalized by skeletal volume (SV) in F-18-fluoride (F-18-NaF) PET/CT studies is lower than variability in SUV normalized by body weight (BW). Methods: The mean SUV (SUVmean) was obtained for whole skeletal volume of interest (wsVOI) in 163 selected F-18-NaF PET/CT studies. These studies were performed to investigate bone metastases and were considered to have normal results. SUVmean was calculated with normalization by BW (BW SUVmean), with normalization by SV (SV SUVmean), and without normalization (WN SUVmean). The total SV for each patient was also estimated on the basis of the wsVOI defined on the CT component of the PET/CT study. SUVmean variability for each patient was estimated as the absolute value of the difference between the SUVmean for the patient and the mean of the SUVmean for the whole group of patients, divided by the mean of the SUVmean for the whole group of patients. The variabilities of SUVmean calculated by the 3 methods were compared using a paired 1-tailed Wilcoxon test. Results: The mean variability for the BW, SV, and WN SUVmean was 0.16, 0.13, and 0.16, respectively. There were statistically significant differences between SV and BW SUVmean variability (P = 0.03) and between SV and WN SUVmean variability (P < 0.01). There was no statistically significant difference between BW and WN SUVmean variability (P = 0.4). Conclusion: In patients with normal F-18-NaF PET/CT results, SV SUVmean presents lower variability than BW SUVmean.
- 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.
- 18F-Fluoride Uptake in Soft Tissue Metastases of Medullary Thyroid Carcinoma as a Marker of Progressive Calcification(2018) DUARTE, Paulo Schiavom; MARIN, Jose Flavio Gomes; COURA FILHO, George Barberio; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoF-18-fluoride (F-18-NaF) uptake in soft tissue metastases of medullary thyroid carcinoma (MTC) has been reported. However, the evolution of these metastatic sites has rarely been assessed. We present a case of F-18-NaF uptake in multiple liver metastases of MTC initially without macroscopic calcification. The CT follow-up studies showed a progressive calcium deposition in the lesions. Therefore, this case suggests that the F-18-NaF uptake in MTC metastases could potentially be a marker of an ongoing calcification process instead of an inert deposit of calcium.