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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bookPart A experiência Inova HC(2022) CERRI, Giovanni GuidobookPart Introduction - Digital transformation in health in post-pandemic future(2022) CERRI, Giovanni Guido- Post-acute sequelae of SARS-CoV-2 infection: relationship of central nervous system manifestations with physical disability and systemic inflammation(2022) BUSATTO, Geraldo F.; ARAUJO, Adriana Ladeira de; CASTALDELLI-MAIA, Joao Mauricio; DAMIANO, Rodolfo Furlan; IMAMURA, Marta; GUEDES, Bruno F.; PINNA, Fabio de Rezende; SAWAMURA, Marcio Valente Yamada; MANCINI, Marcio C.; SILVA, Katia R. da; GARCIA, Michelle L.; SUMITA, Nairo; BRUNONI, Andre Russowsky; DUARTE, Alberto J. da Silva; BURDMANN, Emmanuel A.; KALLAS, Esper G.; CERRI, Giovanni G.; NITRINI, Ricardo; BENTO, Ricardo F.; ROCHA, Vanderson Geraldo; SOUZA, Heraldo Possolo de; MIGUEL, Euripedes C.; CARVALHO, Carlos R. R. de; FORLENZA, Orestes V.; BATISTELLA, Linamara RizzoBackground Despite the multitude of clinical manifestations of post-acute sequelae of SARS-CoV-2 infection (PASC), studies applying statistical methods to directly investigate patterns of symptom co-occurrence and their biological correlates are scarce. Methods We assessed 30 symptoms pertaining to different organ systems in 749 adults (age = 55 +/- 14 years; 47% female) during in-person visits conducted at 6-11 months after hospitalization due to coronavirus disease 2019 (COVID-19), including six psychiatric and cognitive manifestations. Symptom co-occurrence was initially investigated using exploratory factor analysis (EFA), and latent variable modeling was then conducted using Item Response Theory (IRT). We investigated associations of latent variable severity with objective indices of persistent physical disability, pulmonary and kidney dysfunction, and C-reactive protein and D-dimer blood levels, measured at the same follow-up assessment. Results The EFA extracted one factor, explaining 64.8% of variance; loadings were positive for all symptoms, and above 0.35 for 16 of them. The latent trait generated using IRT placed fatigue, psychiatric, and cognitive manifestations as the most discriminative symptoms (coefficients > 1.5, p < 0.001). Latent trait severity was associated with decreased body weight and poorer physical performance (coefficients > 0.240; p <= 0.003), and elevated blood levels of C-reactive protein (coefficient = 0.378; 95% CI 0.215-0.541; p < 0.001) and D-dimer (coefficient = 0.412; 95% CI 0.123-0.702; p = 0.005). Results were similar after excluding subjects with pro-inflammatory comorbidities. Conclusions Different symptoms that persist for several months after moderate or severe COVID-19 may unite within one latent trait of PASC. This trait is dominated by fatigue and psychiatric symptoms, and is associated with objective signs of physical disability and persistent systemic inflammation.
- Value of Primary Rectal Tumor PET/MRI in the Prediction of Synchronic Metastatic Disease(2022) QUEIROZ, Marcelo A.; ORTEGA, Cinthia D.; FERREIRA, Felipe R.; CAPARELI, Fernanda C.; NAHAS, Sergio C.; CERRI, Giovanni G.; BUCHPIGUEL, Carlos A.Purpose: To analyze the associations between positron emission tomography (PET)/magnetic resonance imaging (MRI) features for primary rectal tumors and metastases. Procedures: Between November 2016 and April 2018, 101 patients with rectal adenocarcinoma were included in this prospective study (NCT02537340) for whole-body PET/MRI for baseline staging. Two readers analyzed the PET/MRI; they assessed the semiquantitative PET features of the primary tumor and the N- and M-stages. Another reader analyzed the MRI features for locoregional staging. The reference standard for confirming metastatic disease was biopsy or imaging follow-up. Nonparametric tests were used to compare the PET/MRI features of the participants with or without metastatic disease. Binary logistic regression was used to evaluate the associations between the primary tumor PET/MRI features and metastatic disease. Results: A total of 101 consecutive participants (median age 62 years; range: 33-87 years) were included. Metastases were detected in 35.6% (36 of 101) of the participants. Among the PET/MRI features, higher tumor lesion glycolysis (352.95 vs 242.70; P =.46) and metabolic tumor volume (36.15 vs 26.20; P =.03) were more frequent in patients with than in those without metastases. Additionally, patients with metastases had a higher incidence of PET-positive (64% vs 32%; P =.009) and MRIpositive (56% vs 32%; P =.03) mesorectal lymph nodes, extramural vascular invasion (86% vs 49%; P >.001), and involvement of mesorectal fascia (64% vs 42%; P =.04); there were also differences between the mrT stages of these two groups (P =.008). No differences in the maximum standardized uptake values for the primary tumors in patients with and without metastases were observed (18.9 vs 19.1; P =.56). Multivariable logistic regression showed that extramural vascular invasion on MRI was the only significant predictor (adjusted odds ratio, 3.8 [95% CI: 1.1, 13.9]; P =.001). Conclusion: PET/MRI facilitated the identification of participants with a high risk of metastatic disease, though these findings were based mainly on MRI features.
conferenceObject DETECTION OF MACROSCOPIC LIVER MORPHOLOGICAL CHANGES ON COMPUTED TOMOGRAPHY USING A DEEP LEARNING TECHNIQUE.(2022) ROCHA, Bruno; FERREIRA, Lorena Carneiro; VIANNA, Luis Gustavo Rocha; FERREIRA, Luma Gallacio Gomes; CICONELLE, Ana Claudia Claudia Martins; NORONHA, Alex Da Silva; CORTEZ, Joao M.; NOGUEIRA, Lucas Salume Lima; LEITE, Jean Michel Rocha Sampaio; SILVA FILHO, Mauricio Ricardo Moreira Da; LEITE, Claudia Da Costa; FELIX, Marcelo De Maria; NOMURA, Cesar Higar; GUTIERREZ, Marco Antonio; CERRI, Giovanni Guido; CARRILHO, Flair Jose; ONO, Suzane Kioko- Post-acute sequelae of SARS-CoV-2 infection: relationship of central nervous system manifestations with physical disability and systemic inflammation (May, 10.1017/S0033291722001374, 2020)(2022) BUSATTO, Geraldo F.; ARAUJO, Adriana Ladeira de; CASTALDELLI-MAIA, Joao Mauricio; DAMIANO, Rodolfo Furlan; IMAMURA, Marta; GUEDES, Bruno F.; PINNA, Fabio de Rezende; SAWAMURA, Marcio Valente Yamada; MANCINI, Marcio C.; SILVA, Katia R. da; GARCIA, Michelle L.; SUMITA, Nairo; BRUNONI, Andre Russowsky; DUARTE, Alberto J. da Silva; BURDMANN, Emmanuel A.; KALLAS, Esper G.; CERRI, Giovanni G.; NITRINI, Ricardo; BENTO, Ricardo F.; ROCHA, Vanderson Geraldo; SOUZA, Heraldo Possolo de; MIGUEL, Euripedes C.; CARVALHO, Carlos R. R. de; FORLENZA, Orestes V.; BATISTELLA, Linamara Rizzo
- Management and treatment of decompensated hepatic fibrosis and severe refractory Schistosoma mansoni ascites with transjugular intrahepatic portosystemic shunt(2022) SANTO, Maria Cristina Carvalho do Espirito; GRYSCHEK, Ronaldo Cesar Borges; FARIAS, Alberto Queiroz; ANDRAUS, Wellington; CARVALHO, Noemia Barbosa; LEITE, Olavo Henrique Munhoz; CASTRO, Felipe Correa; CERRI, Giovanni Guido; HYPOLITTI, Gustavo Henrique; CARNEVALE, Francisco Cesar; ASSIS, Andre Moreira deThis study aimed to report the first case of a patient with hepatosplenic schistosomiasis mansoni, refractory ascites and portal vein thrombosis treated with a transjugular intrahepatic portosystemic shunt (TIPS), at the Instituto de Radiologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil. After the procedure, the patient recovered favorably and progressed with portal pressure reduction and no deterioration of the liver function. Endovascular shunt modification is a conservative medical approach that often helps in reducing symptoms significantly, making it a less invasive and a safer alternative to liver transplantation for the treatment of schistosomiasis with portal hypertension.
bookPart The Inova HC experience(2022) CERRI, Giovanni Guido- Combined artificial intelligence and radiologist model for predicting rectal cancer treatment response from magnetic resonance imaging: an external validation study(2022) HORVAT, Natally; VEERARAGHAVAN, Harini; NAHAS, Caio S. R.; BATES, David D. B.; FERREIRA, Felipe R.; ZHENG, Junting; CAPANU, Marinela; FUQUA, James L.; FERNANDES, Maria Clara; SOSA, Ramon E.; JAYAPRAKASAM, Vetri Sudar; CERRI, Giovanni G.; NAHAS, Sergio C.; PETKOVSKA, IvaPurpose To evaluate an MRI-based radiomic texture classifier alone and combined with radiologist qualitative assessment in predicting pathological complete response (pCR) using restaging MRI with internal training and external validation. Methods Consecutive patients with locally advanced rectal cancer (LARC) who underwent neoadjuvant therapy followed by total mesorectal excision from March 2012 to February 2016 (Memorial Sloan Kettering Cancer Center/internal dataset, n = 114, 41% female, median age = 55) and July 2014 to October 2015 (Instituto do Cancer do Estado de Sao Paulo/external dataset, n = 50, 52% female, median age = 64.5) were retrospectively included. Two radiologists (R1, senior; R2, junior) independently evaluated restaging MRI, classifying patients (radiological complete response vs radiological partial response). Model A (n = 33 texture features), model B (n = 91 features including texture, shape, and edge features), and two combination models (model A + B + R1, model A + B + R2) were constructed. Pathology served as the reference standard for neoadjuvant treatment response. Comparison of the classifiers' AUCs on the external set was done using DeLong's test. Results Models A and B had similar discriminative ability (P = 0 .3; Model B AUC = 83%, 95% CI 70%-97%). Combined models increased inter-reader agreement compared with radiologist-only interpretation (x=0.82, 95% CI 0.70-0.89 vs k=0.25, 95% CI 0.11-0.61). The combined model slightly increased junior radiologist specificity, positive predictive value, and negative predictive values (93% vs 90%, 57% vs 50%, and 91% vs 90%, respectively). Conclusion We developed and externally validated a combined model using radiomics and radiologist qualitative assessment, which improved inter-reader agreement and slightly increased the diagnostic performance of the junior radiologist in predicting pCR after neoadjuvant treatment in patients with LARC. [GRAPHICS] .
bookPart Prefácio(2022) CERRI, Giovanni Guido