PAULO SCHIAVOM DUARTE
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, 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
12 resultados
Resultados de Busca
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- Prevalence of exclusive lower extremity metastases at 18F-NaF PET/CT(2015) ORDONES, Monique Beraldo; VALADARES, Agnes Araujo; DUARTE, Paulo Schiavom; SADO, Heitor Naoki; LIMA, Marcos Santos; CARVALHO, Giovanna; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoAbstract Objective: To evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at 18F-NaF PET/CT. Materials and Methods: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies. Results: No exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients. Conclusion: The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases.
- Comparison of Oral and IV 18F-NaF PET/CT Administration in the Assessment of Bone Metastases in Patients With Breast or Prostate Cancers(2023) ROCHA, Nelisa Helena; ZACCHI, Samara Riguete; SADO, Heitor Naoki; BUCHPIGUEL, Carlos Alberto; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo TatitPurposeThe aim of this study was to compare oral and IV administrations of F-18-NaF PET/CT for detection of suspicious bone metastatic lesions of breast and prostate cancers.Patients and MethodsThirty-six patients with breast (n = 23) or prostate (n = 13) cancers and high risk for bone metastases were prospectively evaluated. All patients underwent 2 PET/CT studies after IV and oral F-18-NaF administration within a 2 to 23 days interval between them. The maximum SUVs from the same suspicious lesions (& LE;5 index lesions per patient) in both studies were measured. The target-to-background ratio (TBR), defined as the relation between the lesion maximum SUV and the whole skeletal mean SUV, was calculated for each lesion. The TBRs in the same lesion calculated using the 2 administration routes were compared. The agreements between 2 physicians in the definition of the number of lesions in both studies were also assessed using weighted & kappa;.ResultsOne hundred thirty-four pairs of lesions were analyzed. There was no significant statistical difference between the median TBRs (P = 0.212) for IV (10.33) and oral (10.85). Excellent intraobserver agreement was observed between IV and oral routes: weighted & kappa; of 1.0 (95% confidence interval, 0.92-1.0) and 0.92 (95% confidence interval, 0.81-0.99) for physicians 1 and 2, respectively. The interobserver coefficients were 0.82 and 0.87 for ""oral versus oral"" and ""IV versus IV,"" respectively.Conclusions(18)F-NaF PET/CT studies using oral and IV routes present comparable performance; thus, it is possible to use oral route in patients with difficult venous access.
- Bone and Calcified Soft Tissue Metastases of Medullary Thyroid Carcinoma Better Characterized on F-18-Fluoride PET/CT than on Ga-68-Dotatate PET/CT(2018) DUARTE, Paulo Schiavom; CASTRONEVES, Luciana Audi de; SADO, Heitor Naoki; SAPIENZA, Marcelo Tatit; HOFF, Ana Amelia Fialho de Oliveira; BUCHPIGUEL, Carlos AlbertoHerein, we report a case of a 19-year-old man with multiple endocrine neoplasia type 2B (MEN2B) and medullary thyroid carcinoma (MTC) diagnosed when he was 12 years of age. The patient had previously undergone total thyroidectomy, cervical radiotherapy, and chemotherapy. He progressed with known bone, pulmonary, and lymph node metastases and was scanned with F-18-fluoride (F-18-NaF) and Ga-68-dotatate whole-body positron emission tomography/computed tomography (PET/CT) for metastatic disease monitoring. We found that the MTC bone metastases and soft tissue calcified metastases were better characterized on F-18-NaF PET/CT than on Ga-68-dotatate PET/CT. This case illustrates that the F-18-NaF PET/CT could be helpful not only to the detection of bone metastases but also to the detection of calcified soft tissue metastases in patients with MTC.
- 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.
conferenceObject The receiver operating characteristic (ROC) curve for classification of 18F-NaF uptake on PET/CT(2012) DUARTE, Paulo; COURA FILHO, George; LIMA, Marcos; ONO, Carla; SADO, Heitor; CARVALHO, Giovanna; SAPIENZA, Marcelo; BUCHPIGUEL, CarlosconferenceObject Dynamic F-18-Sodium Fluoride (18F-NaF) PET/CT analysis: a comparison between oral and intravenous 18F-NaF administration in the assessment of breast and prostate cancer patients(2022) ROCHA, N. H.; SADO, H.; BUCHPIGUEL, C. A.; DUARTE, P. S.; SAPIENZA, M. T.- Comparison of(18)F-NaF PET/CT with Other Imaging Methods in the Detection of Bone Metastases in Patients with Medullary Thyroid Cancer: a Report of a Series of 31 Cases(2020) UEDA, Cristina Emiko; DUARTE, Paulo Schiavom; CASTRONEVES, Luciana Audi de; COURA-FILHO, George Barberio; SADO, Heitor Naoki; SAPIENZA, Marcelo Tatit; HOFF, Ana Oliveira; BUCHPIGUEL, Carlos AlbertoPurpose To compare the(18)F-NaF PET/CT studies (F-18-NaF) with other imaging methods in the detection of skeletal metastases (SM) in patients with medullary thyroid cancer (MTC). Methods We retrospectively analyzed 31 patients with MTC who performed(18)F-NaF to assess SM. The results of the(18)F-NaF were compared with other imaging methods performed for metastasis detection:Tc-99-MDP bone scan (BS), magnetic resonance imaging (MRI), contrast-enhanced CT (CT), and(68)Ga-Dotatate and(18)F-FDG PET/CT studies. A qualitative analysis comparing the(18)F-NaF findings with the ones of the other methods was performed, and the results were classified as superior (>), equal (=), and inferior (Results Eleven patients had no bone metastases detected on any of the imaging methods used. Twenty patients presented SM depicted on(18)F-NaF. Of these 20 patients, 12 performed bone scan (in 9(18)F-NaF > BS and in 3(18)F-NaF = BS), 1 performed(18)F-FDG (F-18-NaF > F-18-FDG), 4 performed(68)Ga-Dotatate (in 2(18)F-NaF > Ga-68-Dotatate and in 2(18)F-NaF = Ga-68-Dotatate), 20 performed CT of at least one body segment (in 15(18)F-NaF = CT and in 5(18)F-NaF > CT), and 16 performed MRI of at least one body segment, and in all of them, the(18)F-NaF was equal to the MRI. Beside this, the(18)F-NaF detected SM in body segments not routinely scanned in MRI and CT. Conclusion In patients with MTC, the(18)F-NaF seems to be equal or superior to other imaging modalities in the detection of SM and allows the analysis of the whole skeletal in a single study.
- 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.
- Receiver operating characteristic (ROC) curve for classification of18F-NaF uptake on PET/CT(2016) VALADARES, Agnes Araujo; DUARTE, Paulo Schiavom; CARVALHO, Giovanna; ONO, Carla Rachel; COURA-FILHO, George Barberio; SADO, Heitor Naoki; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoAbstract Objective: To assess the cutoff values established by ROC curves to classify18F-NaF uptake as normal or malignant. Materials and Methods: PET/CT images were acquired 1 hour after administration of 185 MBq of18F-NaF. Volumes of interest (VOIs) were drawn on three regions of the skeleton as follows: proximal right humerus diaphysis (HD), proximal right femoral diaphysis (FD) and first vertebral body (VB1), in a total of 254 patients, totalling 762 VOIs. The uptake in the VOIs was classified as normal or malignant on the basis of the radiopharmaceutical distribution pattern and of the CT images. A total of 675 volumes were classified as normal and 52 were classified as malignant. Thirty-five VOIs classified as indeterminate or nonmalignant lesions were excluded from analysis. The standardized uptake value (SUV) measured on the VOIs were plotted on an ROC curve for each one of the three regions. The area under the ROC (AUC) as well as the best cutoff SUVs to classify the VOIs were calculated. The best cutoff values were established as the ones with higher result of the sum of sensitivity and specificity. Results: The AUCs were 0.933, 0.889 and 0.975 for UD, FD and VB1, respectively. The best SUV cutoffs were 9.0 (sensitivity: 73%; specificity: 99%), 8.4 (sensitivity: 79%; specificity: 94%) and 21.0 (sensitivity: 93%; specificity: 95%) for UD, FD and VB1, respectively. Conclusion: The best cutoff value varies according to bone region of analysis and it is not possible to establish one value for the whole body.
- Incidental diagnosis of struma ovarii through radioiodine whole-body scanning: incremental role of SPECT/CT(2016) VALE, Rômulo Hermeto Bueno do; SADO, Heitor Naoki; DANILOVIC, Débora Lucia Seguro; DUARTE, Pulo Schiavom; SAPIENZA, Marcelo Tatit