MARCIO VALENTE YAMADA SAWAMURA
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
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- Methotrexate and rheumatoid arthritis associated interstitial, Lung disease(2021) JUGE, Pierre-Antoine; LEE, Joyce S.; LAU, Jessica; KAWANO-DOURADO, Leticia; SERRANO, Jorge Rojas; SEBASTIANI, Marco; KODURI, Gouri; MATTESON, Eric; BONFIGLIOLI, Karina; SAWAMURA, Marcio; KAIRALLA, Ronaldo; CAVAGNA, Lorenzo; CASSIONE, Emanuele Bozzalla; MANFREDI, Andreina; MEJIA, Mayra; RODRIGUEZ-HENRIQUEZ, Pedro; GONZALEZ-PEREZ, Montserrat I.; FALFAN-VALENCIA, Ramces; BUENDIA-ROLDAN, Ivette; PEREZ-RUBIO, Gloria; EBSTEIN, Esther; GAZAL, Steven; BORIE, Raphael; OTTAVIANI, Sebastien; KANNENGIESSER, Caroline; WALLAERT, Benoit; UZUNHAN, Yurdagul; NUNES, Hilario; VALEYRE, Dominique; SAIDENBERG-KERMANAC, Nathalie; BOISSIER, Marie-Christophe; WEMEAU-STERVINOU, Lidwine; FLIPO, Rene-Marc; MARCHAND-ADAM, Sylvain; RICHETTE, Pascal; ALLANORE, Yannick; DROMER, Claire; TRUCHETET, Marie-Elise; RICHEZ, Christophe; SCHAEVERBEKE, Thierry; LIOTE, Huguette; THABUT, Gabriel; DEANE, Kevin D.; SOLOMON, Joshua J.; DOYLE, Tracy; RYU, Jay H.; ROSAS, Ivan; HOLERS, V. Michael; BOILEAU, Catherine; DEBRAY, Marie-Pierre; PORCHER, Raphael; SCHWARTZ, David A.; VASSALLO, Robert; CRESTANI, Bruno; DIEUDE, PhilippeQuestion addressed by the study: Methotrexate (MTX) is a key anchor drug for rheumatoid arthritis (RA) management. Fibrotic interstitial lung disease (ILD) is a common complication of RA. Whether MTX exposure increases the risk of ILD in patients with RA is disputed. We aimed to evaluate the association of prior MTX use with development of RA-ILD. Methods: Through a case-control study design with discovery and international replication samples, we examined the association of MTX exposure with ILD in 410 patients with chronic fibrotic ILD associated with RA (RA-ILD) and 673 patients with RA without ILD. Estimates were pooled over the different samples using meta-analysis techniques. Results: Analysis of the discovery sample revealed an inverse relationship between MTX exposure and RA-ILD (adjusted OR 0.46, 95% CI 0.24 0.90; p=0.022), which was confirmed in the replication samples (pooled adjusted OR 0.39, 95% CI 0.19 -0.79; p=0.009). The combined estimate using both the derivation and validation samples revealed an adjusted OR of 0.43 (95% CI 0.26 0.69; p=0.0006). MTX ever-users were less frequent among patients with RA-ILD compared to those without II,D, irrespective of chest high-resolution computed tomography pattern. In patients with RA-ILD, ILD detection was significantly delayed in MTX ever-users compared to never-users (11.4 +/- 10.4 years and 4.0 +/- 7.4 years, respectively; p<0.001). Answer to the question: Our results suggest that MTX use is not associated with an increased risk of RA-ILD in patients with RA, and that ILD was detected later in MTX-treated patients.
- Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal(2021) HOCHHEGGER, Bruno; MARCHIORI, Edson; RODRIGUES, Rosana; MANCANO, Alexandre; JASINOWODOLINSKI, Dany; CHATE, Rodrigo Caruso; JR, Arthur Soares Souza; SILVA, Alexandre Marchini; SAWAMURA, Marcio; FURNARI, Marcelo; ARAUJO-NETO, Cesar; ESCUISSATO, Dante; PINETTI, Rogerio; NOBRE, Luiz Felipe; WARSZAWIAK, Danny; SZARF, Gilberto; TELLES, Gustavo Borges da Silva; MEIRELLES, Gustavo; SANTANA, Pablo Rydz; ANTUNES, Viviane; CAPOBIANCO, Julia; MISSRIE, Israel; SOUZA, Luciana Volpon Soares; SANTOS, Marcel Koeningan; IRION, Klaus; DUARTE, Isabel; SANTOS, Rosana; PINTO, Erique; PENHA, DianaEffective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.
- COVID-19 pneumonia: what is the role of imaging in diagnosis?(2020) ARAUJO-FILHO, Jose de Arimateia Batista; SAWAMURA, Marcio Valente Yamada; COSTA, Andre Nathan; CERRI, Giovanni Guido; NOMURA, Cesar Higa
- Organ doses evaluation for chest computed tomography procedures with TL dosimeters: Comparison with Monte Carlo simulations(2019) GIANSANTE, Louise; MARTINS, Juliana C.; NERSISSIAN, Denise Y.; KIERS, Karen C.; KAY, Fernando U.; SAWAMURA, Marcia V. Y.; LEE, Choonsik; GEBRIM, Eloisa M. M. S.; COSTA, Paulo R.Purpose: To evaluate organ doses in routine and low-dose chest computed tomography (CT) protocols using an experimental methodology. To compare experimental results with results obtained by the National Cancer Institute dosimetry system for CT (NCICT) organ dose calculator. To address the differences on organ dose measurements using tube current modulation (TCM) and fixed tube current protocols. Methods: An experimental approach to evaluate organ doses in pediatric and adult anthropomorphic phantoms using thermoluminescent dosimeters (TLDs) was employed in this study. Several analyses were performed in order to establish the best way to achieve the main results in this investigation. The protocols used in this study were selected after an analysis of patient data collected from the Institute of Radiology of the School of Medicine of the University of Sao Paulo (InRad). The image quality was evaluated by a radiologist from this institution. Six chest adult protocols and four chest pediatric protocols were evaluated. Lung doses were evaluated for the adult phantom and lung and thyroid doses were evaluated for the pediatric phantom. The irradiations were performed using both a GE and a Philips CT scanner. Finally, organ doses measured with dosimeters were compared with Monte Carlo simulations performed with NCICT. Results: After analyzing the data collected from all CT examinations performed during a period of 3 yr, the authors identified that adult and pediatric chest CT are among the most applied protocol in patients in that clinical institution, demonstrating the relevance on evaluating organ doses due to these examinations. With regards to the scan parameters adopted, the authors identified that using 80 kV instead of 120 kV for a pediatric chest routine CT, with TCM in both situations, can lead up to a 28.7% decrease on the absorbed dose. Moreover, in comparison to the standard adult protocol, which is performed with fixed mAs, TCM, and ultra low- dose protocols resulted in dose reductions of up to 35.0% and 90.0%, respectively. Finally, the percent differences found between experimental and Monte Carlo simulated organ doses were within a 20% interval. Conclusions: The results obtained in this study measured the impact on the absorbed dose in routine chest CT by changing several scan parameters while the image quality could be potentially preserved.
conferenceObject Respiratory Symptoms and Altered Physical Exam in Rheumatoid Arthritis Patients with Subclinical Interstitial Lung Abnormalities(2018) KAWANO-DOURADO, L.; SAWAMURA, M. V. Y.; BONFIGLIOLI, K.; ARIMURA, F. E.; LEE, H. J.; RANGEL, D. A. S.; CARVALHO, C. R. R.; DOYLE, T. J.; ROSAS, I. O.; KAIRALLA, R. A.- Baseline Characteristics and Progression of a Spectrum of Interstitial Lung Abnormalities and Disease in Rheumatoid Arthritis(2020) KAWANO-DOURADO, Leticia; DOYLE, Tracy J.; BONFIGLIOLI, Karina; SAWAMURA, Marcio V. Y.; NAKAGAWA, Renato H.; ARIMURA, Fabio E.; LEE, Hye J.; RANGEL, Diana Arrais de Souza; BUENO, Cleonice; CARVALHO, Carlos R. R.; SABBAG, Maria Laura; MOLINA, Camila; ROSAS, Ivan O.; KAIRALLA, Ronaldo A.BACKGROUND Interstitial lung abnormalities (ILA) and interstitial lung disease (ILD) are seen in up to 60% of individuals with rheumatoid arthritis (RA), some of which will progress to have a significant impact on morbidity and mortality rates. Better characterization of progressive interstitial changes and identification of risk factors that are associated with progression may enable earlier intervention and improved outcomes. RESEARCH QUESTION. What are baseline characteristics associated with RA-ILD progression? STUDY DESIGN AND METHOD! We performed a retrospective study in which all clinically indicated CT chest scans in adult individuals with RA from 2014 to 2016 were evaluated for interstitial changes, and the data were further subdivided into ILA and ILD based on clinical record review. Progression was determined visually and subsequently semiquantified. RESULTS. Those individuals with a spectrum of interstitial changes (64 of 293) were older male smokers and less likely to be receiving biologics/small molecule disease-modifying antirheumatic drugs. Of 44% of the individuals with ILA, 46% had had chest CT scans performed for nonpulmonary indications. Of the 56 individuals with ILA/ILD with sequential CT scans, 38% had evidence of radiologic progression over 4.4 years; 29% of of individuals with ILA progressed. Risk factors for progressive ILA/ILD included a subpleural distribution and higher baseline involvement. INTERPRETATION. Of 293 individuals with RA with clinically indicated CT scans, interstitial changes were observed in 22%, one-half of whom had had a respiratory complaint at the time of imaging; radiologic progression was seen in 38%. Of individuals with progressive ILA, one-half had had baseline CT scans performed for nonpulmonary indications. Subpleural distribution and higher baseline ILA/ILD extent were risk factors associated with progression. Prospective longi- tudinal studies of RA-ILA are necessary.
- METHOTREXATE AND RHEUMATOID ARTHRITIS ASSOCIATED INTERSTITIAL LUNG DISEASE(2020) JUGE, P. A.; LEE, J. S.; LAU, J.; KAWANO, L.; ROJAS-SERRANO, J.; SEBASTIANI, M.; KODURI, G.; MATTESON, E.; BONFIGLIOLI, K.; SAWAMURA, M.; KAIRALLA, R.; CAVAGNA, L.; CASSIONE, E. Bozzalla; MANFREDI, A.; MEJIA, M.; HENRIQUEZ, P. Rodriguez; GONZALEZ-PEREZ, M. I.; FALFAN-VALENCIA, R.; BUENDIA-ROLDAN, I.; PEREZ-RUBIO, G.; EBSTEIN, E.; GAZAL, S.; BORIE, R.; OTTAVIANI, S.; KANNENGIESSER, C.; WALLAERT, B.; UZUNHAN, Y.; NUNES, H.; VALEYRE, D.; KERMANAC'H, N. Saidenberg; BOISSIER, M. C.; STERVINOU, L. Wemeau; FLIPO, R. M.; MARCHAND-ADAM, S.; RICHETTE, P.; ALLANORE, Y.; DROMER, C.; TRUCHETET, M. E.; RICHEZ, C.; SCHAEVERBEKE, T.; LIOTE, H.; THABUT, G.; DEANE, K.; SOLOMON, J.; DOYLE, T.; RYU, J. H.; ROSAS, I. O.; HOLERS, V. M.; BOILEAU, C.; DEBRAY, M. P.; PORCHER, R.; SCHWARTZ, D. A.; VASSALLO, R.; CRESTANI, B.; DIEUDE, P.
- Diagnostic reference level quantities for adult chest and abdomen-pelvis CT examinations: correlation with organ doses(2023) COSTA, Paulo Roberto; TOMAL, Alessandra; CASTRO, Jullianna Cristina de Oliveira; NUNES, Isabella Paziam Fernandes; NERSISSIAN, Denise Yanikian; SAWAMURA, Marcio Valente Yamada; LEAO FILHO, Hilton; LEE, ChoonsikObjectivesTo evaluate correlations between DRL quantities (DRLq) stratified into patient size groups for non-contrast chest and abdomen-pelvis CT examinations in adult patients and the corresponding organ doses.MethodsThis study presents correlations between DRLq (CTDIvol, DLP and SSDE) stratified into patient size ranges and corresponding organ doses shared in four groups: inside, peripheral, distributed and outside. The demographic, technical and dosimetric parameters were used to identify the influence of these quantities in organ doses. A robust statistical method was implemented in order to establish these correlations and its statistical significance.ResultsMedian values of the grouped organ doses are presented according to the effective diameter ranges. Organ doses in the regions inside the imaged area are higher than the organ doses in peripheral, distributed and outside regions, excepted to the peripheral doses associated with chest examinations. Different levels of statistical significance between organ doses and the DRLq were presented.ConclusionsCorrelations between DRLq and target-organ doses associated with clinical practice can support guidance's to the establishment of optimization criteria. SSDE demonstrated to be significant in the evaluation of organ doses is also highlighted. The proposed model allows the design of optimization actions with specific risk-reduction results.