JOSE WILLEGAIGNON DE AMORIM DE CARVALHO

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LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina

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  • article 20 Citação(ões) na Scopus
    Radionuclide therapy: current status and prospects for internal dosimetry in individualized therapeutic planning
    (2019) SAPIENZA, Marcelo Tatit; WILLEGAIGNON, Jose
    The efficacy and toxicity of radionuclide therapy are believed to be directly related to the radiation doses received by target tissues; however, nuclear medicine therapy continues to be based primarily on the administration of empirical activities to patients and less frequently on the use of internal dosimetry for individual therapeutic planning. This review aimed to critically describe the techniques and clinical evidence of dosimetry as a tool for therapeutic planning and the main limitations to its implementation in clinical practice. The present article is a nonsystematic review of voxel-based dosimetry. Clinical evidence pointing to a correlation between the radiation dose and therapeutic response in various diseases, such as thyroid carcinoma, neuroendocrine tumors and prostate cancer, is reviewed. Its limitations include technical aspects related to image acquisition and processing and the lack of randomized clinical trials demonstrating the impact of dosimetry on patient therapy. A more widespread use of dosimetry in therapeutic planning involves the development of user-friendly dosimetric protocols and confirmation that dose estimation implies good efficacy and low treatment-related toxicity.
  • article 3 Citação(ões) na Scopus
    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 Alberto
    Our 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.