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
4 resultados
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- Intramastoid Phosphaturic Mesenchymal Tumor Causing Hypophosphatemic Osteomalacia Detected on Ga-68-DOTATATE PET/CT But Not on Tc-99m-Sestamibi and F-18-FDG Scans(2019) ARAUJO, Carlo Scognamiglio Renner; SEGURO, Luciana Parente Costa; DUARTE, Paulo Schiavom; BUCHPIGUEL, Carlos Alberto; PEREIRA, Rosa Maria RodriguesGa-68-DOTATATE uptake in mesenchymal tumors causing hypophosphatemic osteomalacia has been recently described. Herein, we present a case of Ga-68-DOTATATE uptake in an intramastoid phosphaturic mesenchymal tumor that had not been depicted in previous Tc-99m-Sestamibi and F-18-FDG scans. The lesion was surgically removed and the phosphorus level increased to the normal range.
- Ga-68-DOTATATE PET: temporal variation of maximum standardized uptake value in normal tissues and neuroendocrine tumours(2019) COURA-FILHO, George Barberio; HOFF, Ana A. F. O.; DUARTE, Paulo S.; BUCHPIGUEL, Carlos A.; JOSEFSSON, Anders; HOBBS, Robert F.; SGOUROS, George; SAPIENZA, Marcelo T.Objectives Higher affinity of Ga-68 compounds to somatostatin receptors (SSTRs) and PET better image resolution increased interest in Ga-68-labelled somatostatin analogs in the management of neuroendocrine tumours (NETs). This study aimed to evaluate the maximum standardized uptake value (SUVmax) variation in sequential somatostatin analogs-PET in NET patients and identify optimal tumour detection and characterization imaging time. Methods Patients with histological or biochemical NET diagnosis performed two to three PET/computed tomography (CT) scans after intravenous injection of Ga-68-DOTATATE: Early PET [EarlyPET: <15 minutes postinjection (p.i.)], diagnostic PET (DiagPET: 45-90 minutes p.i.) and delayed PET (DelayPE: 90-240 minutes p.i.). Up to five tumour sites and normal tissues had SUVmax determined. Time-SUVmax curves were created for the target lesions and normal organs. Ratios between tumour and liver SUVmax (SUVTU/Liver) and tumour/blood pool (SUVTU/BP) were also calculated. Results Twenty-nine patients were included, 16 female, mean age of 46.5 +/- 14.3 years. Average administered activity was 129.5 +/- 29.6 MBq. Kidneys SUVmax was higher in EarlyPET compared with DiagPET (P = 0.04) and DelayPET showed higher SUVmax compared with DiagPET for normal liver, pancreas and kidneys (P = 0.02). No differences were noted between EarlyPET, DiagPET and DelayPET in tumour SUVmax (P > 0.05). SUVTU/Liver and SUVTU/BP did not change between EarlyPET and DiagPET, with a slight decrease in DelayPET. Conclusion Stability in tumour SUVmax values measured at different intervals independently of tumour location, as also in normal tissues as kidneys and liver suggest that a more flexible imaging protocol may be adopted.
- 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.
- Introducing FDG PET/CT-guided chemoradiotherapy for stage III NSCLC in low- and middle-income countries: preliminary results from the IAEA PERTAIN trial(2019) KONERT, T.; VOGEL, W. V.; PAEZ, D.; POLO, A.; FIDAROVA, E.; CARVALHO, H.; DUARTE, P. S.; ZULIANI, A. C.; SANTOS, A. O.; ALTUHHOVA, D.; KARUSOO, L.; KAPOOR, R.; SOOD, A.; KHADER, J.; AL-IBRAHEEM, A.; NUMAIR, Y.; ABUBAKER, S.; SOYDAL, C.; KUTUK, T.; LE, T. A.; CANH, N. X.; BIEU, B. Q.; HA, L. N.; BELDERBOS, J. S. A.; MACMANUS, M. P.; THORWARTH, D.; HANNA, G. G.Purpose Patients with stage III non-small-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT) in low- and middle-income countries (LMIC) continue to have a poor prognosis. It is known that FDG PET/CT improves staging, treatment selection and target volume delineation (TVD), and although its use has grown rapidly, it is still not widely available in LMIC. CRT is often used as sequential treatment, but is known to be more effective when given concurrently. The aim of the PERTAIN study was to assess the impact of introducing FDG PET/CT-guided concurrent CRT, supported by training and quality control (QC), on the overall survival (OS) and progression-free survival (PFS) of patients with stage III NSCLC. Methods The study included patients with stage III NSCLC from nine medical centres in seven countries. A retrospective cohort was managed according to local practices between January 2010 and July 2014, which involved only optional diagnostic FDG PET/CT for staging (not for TVD), followed by sequential or concurrent CRT. A prospective cohort between August 2015 and October 2018 was treated according to the study protocol including FDG PET/CT in treatment position for staging and multimodal TVD followed by concurrent CRT by specialists trained in protocol-specific TVD and with TVD QC. Kaplan-Meier analysis was used to assess OS and PFS in the retrospective and prospective cohorts. Results Guidelines for FDG PET/CT image acquisition and TVD were developed and published. All specialists involved in the PERTAIN study received training between June 2014 and May 2016. The PET/CT scanners used received EARL accreditation. In November 2018 a planned interim analysis was performed including 230 patients in the retrospective cohort with a median follow-up of 14 months and 128 patients in the prospective cohort, of whom 69 had a follow-up of at least 1 year. Using the Kaplan-Meier method, OS was significantly longer in the prospective cohort than in the retrospective cohort (23 vs. 14 months, p = 0.012). In addition, median PFS was significantly longer in the prospective cohort than in the retrospective cohort (17 vs. 11 months, p = 0.012). Conclusion In the PERTAIN study, the preliminary results indicate that introducing FDG PET/CT-guided concurrent CRT for patients with stage III NSCLC in LMIC resulted in a significant improvement in OS and PFS. The final study results based on complete data are expected in 2020.