DANIELA ANDRADE FERRARO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, 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
4 resultados
Resultados de Busca
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- Quantitative imaging parameters to predict the local staging of prostate cancer in intermediate- to high-risk patients(2022) LAUDICELLA, Riccardo; SKAWRAN, Stephan; FERRARO, Daniela A.; MUHLEMATTER, Urs J.; MAURER, Alexander; GRUNIG, Hannes; RUSCHOFF, Hendrik J.; RUPP, Niels; DONATI, Olivio; EBERLI, Daniel; BURGER, Irene A.Objectives PSMA PET/MRI showed the potential to increase the sensitivity for extraprostatic disease (EPD) assessment over mpMRI; however, the interreader variability for EPD is still high. Therefore, we aimed to assess whether quantitative PSMA and mpMRI imaging parameters could yield a more robust EPD prediction. Methods We retrospectively evaluated PCa patients who underwent staging mpMRI and [Ga-68]PSMA-PET, followed by radical prostatectomy at our institution between 01.02.2016 and 31.07.2019. Fifty-eight cases with PET/MRI and 15 cases with PET/CT were identified. EPD was determined on histopathology and correlated with quantitative PSMA and mpMRI parameters assessed by two readers: ADC (mm(2)/1000 s), longest capsular contact (LCC, mm), tumor volume (cm(3)), PSMA-SUVmax and volume-based parameters using a fixed threshold at SUV > 4 to delineate PSMA(total) (g/ml) and PSMA(vol) (cm(3)). The t test was used to compare means, Pearson's test for categorical correlation, and ROC curve to determine the best cutoff. Interclass correlation (ICC) was performed for interreader agreement (95% CI). Results Seventy-three patients were included (64.5 +/- 6.0 years; PSA 14.4 +/- 17.1 ng/ml), and 31 had EPD (42.5%). From mpMRI, only LCC reached significance (p = 0.005), while both volume-based PET parameters PSMA(total) and PSMA(vol) were significantly associated with EPD (p = 0.008 and p = 0.004, respectively). On ROC analysis, LCC, PSMA(total), and PSMA(vol) reached an AUC of 0.712 (p = 0.002), 0.709 (p = 0.002), and 0.718 (p = 0.002), respectively. ICC was moderate-good for LCC 0.727 (0.565-0.828) and excellent for PSMA(total) and PSMA(vol) with 0.944 (0.990-0.996) and 0.985 (0.976-0.991), respectively. Conclusions Quantitative PSMA parameters have a similar potential as mpMRI LCC to predict EPD of PCa, with a significantly higher interreader agreement.
- Ga-68-PSMA-11 PET/MRI versus multiparametric MRI in men referred for prostate biopsy: primary tumour localization and interreader agreement(2022) FERRARO, Daniela A.; HOETKER, Andreas M.; BECKER, Anton S.; MEBERT, Iliana; LAUDICELLA, Riccardo; BALTENSPERGER, Anka; RUPP, Niels J.; RUESCHOFF, Jan H.; MUELLER, Julian; MORTEZAVI, Ashkan; SAPIENZA, Marcelo T.; EBERLI, Daniel; DONATI, Olivio F.; BURGER, Irene A.Background Magnetic resonance imaging (MRI) is recommended by the European Urology Association guidelines as the standard modality for imaging-guided biopsy. Recently positron emission tomography with prostate-specific membrane antigen (PSMA PET) has shown promising results as a tool for this purpose. The aim of this study was to compare the accuracy of positron emission tomography with prostate-specific membrane antigen/magnetic resonance imaging (PET/MRI) using the gallium-labeled prostate-specific membrane antigen (Ga-68-PSMA-11) and multiparametric MRI (mpMRI) for pre-biopsy tumour localization and interreader agreement for visual and semiquantitative analysis. Semiquantitative parameters included apparent diffusion coefficient (ADC) and maximum lesion diameter for mpMRI and standardized uptake value (SUVmax) and PSMA-positive volume (PSMA(vol)) for PSMA PET/MRI. Results Sensitivity and specificity were 61.4% and 92.9% for mpMRI and 66.7% and 92.9% for PSMA PET/MRI for reader one, respectively. RPE was available in 23 patients and 41 of 47 quadrants with discrepant findings. Based on RPE results, the specificity for both imaging modalities increased to 98% and 99%, and the sensitivity improved to 63.9% and 72.1% for mpMRI and PSMA PET/MRI, respectively. Both modalities yielded a substantial interreader agreement for primary tumour localization (mpMRI kappa = 0.65 (0.52-0.79), PSMA PET/MRI kappa = 0.73 (0.61-0.84)). ICC for SUVmax, PSMA(vol) and lesion diameter were almost perfect (>= 0.90) while for ADC it was only moderate (ICC = 0.54 (0.04-0.78)). ADC and lesion diameter did not correlate significantly with Gleason score (rho = 0.26 and rho = 0.16) while SUVmax and PSMA(vol) did (rho = - 0.474 and rho = - 0.468). Conclusions PSMA PET/MRI has similar accuracy and reliability to mpMRI regarding primary prostate cancer (PCa) localization. In our cohort, semiquantitative parameters from PSMA PET/MRI correlated with tumour grade and were more reliable than the ones from mpMRI.
- Bone marrow uptake of 18F-fluorodeoxyglucose in Hodgkin lymphoma without bone involvement: comparison between patients with and without B symptoms(2018) VALE, Rômulo Hermeto Bueno do; FERRARO, Daniela Andrade; DUARTE, Paulo Schiavom; CARVALHO, Giovana; LIMA, Marcos Santos; COURA FILHO, George Barbério; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoAbstract Objective: To compare the degree of benign bone marrow uptake of 18F-fluorodeoxyglucose (18F-FDG) between Hodgkin lymphoma patients with and without B symptoms. Materials and Methods: We analyzed the medical charts of 74 Hodgkin lymphoma patients who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) prior to the initiation of therapy between October 2010 and September 2013. In all of the patients, the bone marrow biopsy was negative and the 18F-FDG PET/CT images did not suggest bone marrow involvement. Of the 74 patients evaluated, 54 presented inflammatory (B) symptoms and 20 did not. Regions of interest (ROIs) were drawn on the sternum, the proximal thirds of the humeri, the proximal thirds of the femora, and both iliac wings (totaling seven ROIs per patient). To compare the patients with and without B symptoms, in terms of standardized uptake values (SUVs) for the seven ROIs, we used the Mann-Whitney U test. Results: For six of the ROIs, the SUVs were higher in the patients with B symptoms than in those without, and the difference was statistically significant (p < 0.05). There was also a tendency toward a statistically significant difference between the two groups in terms of the SUV for the right iliac wing ROI (p = 0.06). Conclusion: In our sample, the presence of B symptoms was associated with increased 18F-FDG uptake in bone marrow.
- Development and external validation of a multivariable [68Ga]Ga-PSMA-11 PET-based prediction model for lymph node involvement in men with intermediate or high-risk prostate cancer(2023) MUEHLEMATTER, Urs J.; SCHWEIGER, Lilit; FERRARO, Daniela A.; HERMANNS, Thomas; MAURER, Tobias; HECK, Matthias M.; RUPP, Niels J.; EIBER, Matthias; RAUSCHER, Isabel; BURGER, Irene A.PurposeTo develop and evaluate a lymph node invasion (LNI) prediction model for men staged with [Ga-68]Ga-PSMA-11 PET.MethodsA consecutive sample of intermediate to high-risk prostate cancer (PCa) patients undergoing [Ga-68]Ga-PSMA-11 PET, extended pelvic lymph node dissection (ePLND), and radical prostatectomy (RP) at two tertiary referral centers were retrospectively identified. The training cohort comprised 173 patients (treated between 2013 and 2017), the validation cohort 90 patients (treated between 2016 and 2019). Three models for LNI prediction were developed and evaluated using cross-validation. Optimal risk-threshold was determined during model development. The best performing model was evaluated and compared to available conventional and multiparametric magnetic resonance imaging (mpMRI)-based prediction models using area under the receiver operating characteristic curves (AUC), calibration plots, and decision curve analysis (DCA).ResultsA combined model including prostate-specific antigen, biopsy Gleason grade group, [Ga-68]Ga Ga-PSMA-11 positive volume of the primary tumor, and the assessment of the [Ga-68]Ga-PSMA-11 report N-status yielded an AUC of 0.923 (95% CI 0.863-0.984) in the external validation. Using a cutoff of >= 17%, 44 (50%) ePLNDs would be spared and LNI missed in one patient (4.8%). Compared to conventional and MRI-based models, the proposed model showed similar calibration, higher AUC (0.923 (95% CI 0.863-0.984) vs. 0.700 (95% CI 0.548-0.852)-0.824 (95% CI 0.710-0.938)) and higher net benefit at DCA.ConclusionsOur results indicate that information from [Ga-68]Ga-PSMA-11 may improve LNI prediction in intermediate to high-risk PCa patients undergoing primary staging especially when combined with clinical parameters. For better LNI prediction, future research should investigate the combination of information from both PSMA PET and mpMRI for LNI prediction in PCa patients before RP.