JOSE FLAVIO GOMES MARIN
Projetos de Pesquisa
Unidades Organizacionais
14 resultados
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- Reassessing Patterns of Response to Immunotherapy with PET: From Morphology to Metabolism(2021) COSTA, Larissa B.; QUEIROZ, Marcelo A.; BARBOSA, Felipe G.; NUNES, Rafael F.; ZANIBONI, Elaine C.; RUIZ, Mariana Mazo; JARDIM, Denis; MARIN, Jose Flavio Gomes; CERRI, Giovanni G.; BUCHPIGUEL, Carlos A.Cancer demands precise evaluation and accurate and timely assessment of response to treatment. Imaging must be performed early during therapy to allow adjustments to the course of treatment. For decades, cross-sectional imaging provided these answers, showing responses to the treatment through changes in tumor size. However, with the emergence of immune checkpoint inhibitors, complex immune response patterns were revealed that have quickly highlighted the limitations of this approach. Patterns of response beyond tumor size have been recognized and include cystic degeneration, necrosis, hemorrhage, and cavitation. Furthermore, new unique patterns of response have surfaced, like pseudoprogression and hyperprogression, while other patterns were shown to be deceptive, such as unconfirmed progressive disease. This evolution led to new therapeutic evaluation criteria adapted specifically for immunotherapy. Moreover, inflammatory adverse effects of the immune checkpoint blockade were identified, many of which were life threatening and requiring prompt intervention. Given complex concepts like tumor microenvironment and novel therapeutic modalities in the era of personalized medicine, increasingly sophisticated imaging techniques are required to address the intricate patterns of behavior of different neoplasms. Fluorine 18-fluorodeoxyglucose PET/CT has rapidly emerged as one such technique that spans both molecular biology and immunology. This imaging technique is potentially capable of identifying and tracking prognostic biomarkers owing to its combined use of anatomic and metabolic imaging, which enables it to characterize biologic processes in vivo. This tailored approach may provide whole-body quantification of the metabolic burden of disease, providing enhanced prediction of treatment response and improved detection of adverse events. (C) RSNA, 2020
- 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
- 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.
- 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.
- Pseudoprogression on PSMA PET imaging of a mCRPC patient under anti-PD1 treatment(2019) COSTA, Larissa Bastos; QUEIROZ, Marcelo Araujo; BARBOSA, Felipe de Galiza; NUNES, Rafael Fernandes; MARIN, Jose Flavio Gomes; DZIK, Carlos; BUCHPIGUEL, Carlos Alberto
- 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.
- Concerns about Prognostic Meaning of Quantitative PET Analysis in Classical Hodgkin Lymphoma(2022) SANTOS, Fernanda Maria Maria; MARIN, Jose Flavio Gomes; LIMA, Marcos Santos; SILVA, Wellington F.; VELASQUES, Rodrigo D.; MAIA, Ana Carolina Arrais; ATANAZIO, Marcelo Junqueira; ALVES, Lucas Bassolli de Oliveira; MOREIRA, Frederico Rafael; BUCHPIGUEL, Carlos Alberto; BUCCHERI, Valeria; ROCHA, Vanderson
- 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.