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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- Effects of Prostatic Artery Embolization on the Dynamic Component of Benign Prostate Hyperplasia as Assessed by Ultrasound Elastography: A Pilot Series(2019) ASSIS, Andre Moreira de; MOREIRA, Airton Mota; CARNEVALE, Francisco Cesar; MARCELINO, Antonio Sergio Zafred; CERRI, Luciana Mendes de Oliveira; ANTUNES, Alberto Azoubel; SROUGI, Miguel; CERRI, Giovanni GuidoPurposeTo determine the effects of prostatic artery embolization (PAE) on prostaticelasticity as assessed by Ultrasound Elastography (US-E), as well as to describe the feasibility and role of US-E as a novel tool in both pre- and post-PAE evaluation.Materials and MethodsThis is a prospective, single-center investigation that included eight patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline and 3-month follow-up evaluations were performed and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. US-E with measurement of the prostatic Elastic Modulus (EM) was performed before PAE and at 1-month follow-up.ResultsAfter PAE, US-E showed a significant reduction of prostatic EM as assessed in kPa (33.14 vs. 47.24, -29.8%, p=0.002) and in m/s (3.75 vs. 4.63, -19.0%, p<0.001). Also, the transitional/peripheral zone ratio was significantly reduced by 45.36% (0.53 vs. 0.97, p<0.05). All eight patients presented with significant LUTS improvement after PAE (p<0.05 for IPSS, QoL, prostate volume, peak urinary flow rate and PSA).ConclusionsFindings described in this study suggest that PAE significantly reduces prostaticEM, leading to a positive effect on BPH dynamic component related to prostatic elasticity. Also, it features US-E as an additional tool for pre- and post-PAE evaluation, describing a novel indication for this technology.
bookPart Breve histórico cronológico da Residência Médica em Radiologia(2019) GOMES, Regina Lúcia Elia; CERRI, Giovanni Guido; ROCHA, Manoel de Souza- Revisiting Prostate Cancer Recurrence with PSMA PET: Atlas of Typical and Atypical Patterns of Spread(2019) BARBOSA, Felipe G.; QUEIROZ, Marcelo A.; NUNES, Rafael F.; VIANA, Publio C. C.; MARIN, Jose Flavio G.; CERRI, Giovanni G.; BUCHPIGUEL, Carlos A.The introduction of prostate-specific membrane antigen (PSMA) in clinical practice has revolutionized evaluation of biochemical recurrence of prostate cancer after curative-intent treatment. The high expression of this glycoprotein in prostate cancer cells makes PSMA imaging superior to the current conventional staging methods, namely bone scanning and CT. The high capability of PSMA imaging for identifying very small previously undetected lesions has been widely demonstrated in the literature, leading to a rethinking of patient management by oncologists, urologists, and radiation oncologists. The typical and predictable patterns of spread in prostate cancer are still more prevalent, such as spread to pelvic lymph nodes and bone metastasis, but different patterns of disease spread are becoming more commonly recognized with higher reliability because PSMA imaging allows detection of more typical and atypical lesions than conventional imaging. Furthermore, it is important for the reading physician to recognize and understand the typical disease spread and the most prevalent atypical prostate cancer relapses, not only to heighten the relevancy of reports but also to improve imaging consultancy in multispecialty oncologic practice. (C) RSNA, 2019.
- Impact of 5-Alpha-Reductase Inhibitors Use at the Time of Prostatic Artery Embolization for Treatment of Benign Prostatic Obstruction(2019) CARDARELLI-LEITE, Leandro; ASSIS, Andre M. de; MOREIRA, Airton M.; ANTUNES, Alberto A.; CERRI, Giovanni G.; SROUGI, Miguel; CARNEVALE, Francisco C.Purpose: To compare the 12-month post-prostatic artery embolization (PAE) clinical outcomes of patients who were and were not taking 5-alpha-reductase inhibitors (5ARIs) at the time of PAE. Materials and Methods: A retrospective review was conducted of patients who underwent PAE from 2010 to 2017 due to lower urinary tract symptoms, secondary to benign prostatic hyperplasia (BPH). One hundred fifty-five patients were included and divided in 2 groups; these groups did not present statistically significant differences in their baseline characteristics-those taking 5ARIS (Y-5ARIs, n = 40) and those not taking 5ARIs (N-5ARIs, n = 115). International Prostate Symptom Score (IPSS), the sub-item Quality of Life (QoL), and the incidence of clinical failure were used as primary endpoints. Secondary endpoints included mean prostate volume reduction and mean peak flow rate (Q(max)) improvement. Clinical failure or recurrence was defined as absence of symptomatic improvement (IPSS >= 8 or QoL >= 3) or the need for invasive BPH treatment (PAE or transurethral resection of the prostate) during the 12-month follow-up period. Results: After 12-month follow-up, IPSS, QoL, and prostatic volume were significantly lower compared to baseline in both groups, and Q(max) showed a significant increase. No statistically significant differences were observed in outcomes between N-5ARIs and Y-5ARIs, and the clinical failure rate for both groups was approximately 20%. Conclusions: The use of 5ARIs did not show a detrimental effect on clinical outcomes of PAE, in either subjective (IPSS, QoL, and clinical failure) or objective (prostatic volume and Q(max)) parameters.
- 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.
- Defining clinical workflow and PSMA PET/MR protocol for prostate cancer evaluation: Initial experience and results(2019) QUEIROZ, M. A.; FERRARO, D. A.; BUCHPIGUEL, C. A.; CERRI, G. G.Purpose.-To evaluate the clinical workflow and the PET/MR protocol of prostate cancer (PCa) evaluation according to the indication. Methods.-Eleven patients underwent to PSMA PET/MR both for primary staging (PS) and assessment of biochemical recurrence (BCR) of PCa. The clinical workflow was evaluated regarding patient preparation, total uptake time and total acquisition time. The PET/MR protocol was defined according to indication, using a biparametric MRI for PS and a multiparametric MRI for BCR. One reader analyzed the PET/MR for TNM lesion in the PS setting and for locoregional and distant metastasis in the BCR patients. Results.-Four patients (36%) were included for PS and 7 (64%) for assessing BCR of prostate cancer. PSA levels ranged from 0.26 to 33.94 ng/mL and the most prevalent ISUP grade score was 3 (4/11 patients). The average total scan time when including DCE-MR was 73 minutes versus 64 minutes when performing biparametric MR. Nine out of the eleven (82%) patients presented positive findings on PSMA PET/MR. The most prevalent site of disease was local (primary or recurrent tumor) in 6/11 patients (55%) followed by regional lymph nodes in 4/11 (36%). In primary staging patients, the PCa index lesion was depicted in all four patients. In BCR patients, five out of seven patients had positive PET/MR scans. Conclusion.-PET/MRI for prostate cancer evaluation is feasible with a tolerable scan time and, although very preliminary, it reinforces the high detection rate of PSMA PET imaging both for PS and for assessment of BCR.
- Chronic traumatic encephalopathy - a study in Brazilian retired soccer players(2019) LANOF, Jessica Natuline; AREZA-FEGYVERES, Renata; GUARIGLIA, Carla; FREIRE, Fabio; NADRUZ, Patr Prime Icia; CERASI, Alessandra; LEITE, Claudia; PASTORELLO, Bruno; CERRI, Giovanni Guido; ANGHINAH, Renato