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
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- Prognostic value of F-18-fluorodeoxyglucose PET/computed tomography metabolic parameters measured in the primary tumor and suspicious lymph nodes before neoadjuvant therapy in patients with esophageal carcinoma(2021) TUSTUMI, Francisco; DUARTE, Paulo Schiavom; ALBENDA, David Gutierrez; TAKEDA, Flavio Roberto; SALLUM, Rubens Antonio Aissar; RIBEIRO JUNIOR, Ulysses; BUCHPIGUEL, Carlos Alberto; CECCONELLO, IvanBackground F-18-fluorodeoxyglucose PET/computed tomography (F-18-FDG PET/CT) metabolic parameters are prognostic indicators in several neoplasms. This study aimed to evaluate the prognostic value of the maximum and average standardized uptake value (SUVmax and SUVavg), metabolic tumor value (MTV), and total lesion glycolysis (TLG) measured in the primary tumor and suspicious lymph nodes preneoadjuvant therapy in patients submitted to surgical resection for esophageal cancer. Methods A cohort of 113 patients with esophageal cancer who performed F-18-FDG PET/CT preneoadjuvant therapy was assessed. The association of the SUV, MTV, and TLG measured in the primary tumor and in the suspicious lymph nodes with the overall survival was assessed. It was also analyzed other potentially confounding variables such as age, sex, clinical stage, and histologic subtype. The analyses were performed using Kaplan-Meier curve, log-rank test, and Cox regression. Results The univariate analyses showed that the MTV and TLG in the primary tumor, the SUV in the suspicious lymph nodes, the age, the histologic subtype, and the clinical stage were associated with survival after surgery (P <= 0.05). In the Cox regression multivariate analyses, all variables identified in the univariate analyses but the clinical stage were associated with survival after surgery (P <= 0.05). Conclusion In esophageal cancer patients, some of the F-18-FDG PET/CT metabolic parameters measured in the primary tumor and in the suspicious lymph nodes before the neoadjuvant therapy are independent indicators of overall survival and appear to be more important than the clinical stage in the prognostic definition of this group of patients.
- 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.
- 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.
- Iodine/FDG ""Flip-Flop"" Phenomenon Inside a Large Metastatic Thyroid Cancer Lesion Better Characterized on SPECT/CT and PET/CT Studies(2018) DUARTE, Paulo Schiavom; MARIN, Jose Flavio Gomes; CARVALHO, Jose Willegaignon de Amorim de; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoIodine/FDG flip-flop phenomenon inside large metastatic thyroid cancer lesions has been rarely described. We present a case of this phenomenon better characterized using SPECT/CT and PET/CT studies.
- PET/CT Study Performed After an Oral Administration of F-18-Fluoride(2013) ZACCHI, Samara Riguete; VALADARES, Agnes Araujo; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoA 52-year-old woman with right breast cancer was referred for F-18-fluoride whole-body PET/CT for the assessment of bone metastases. The peripheral IV access was not obtained after multiple attempts. The radiopharmaceutical was administered by oral route.
- Preliminary Comparison of PET/CT Studies Performed After Intravenous and Oral Administration of F-18-Fluoride(2016) ZACCHI, Samara Riguete; VALE, Romulo Hermeto Bueno do; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoA 78-year-old man with prostate cancer was referred for F-18-NaF PET/CT for assessing bone metastases. An F-18-NaF PET/CT study was performed after the intravenous administration of the radiopharmaceutical. Five days later, a second study was done after oral administration of the radiopharmaceutical as part of a research protocol.
- Brain Metastasis of Medullary Thyroid Carcinoma Without Macroscopic Calcification Detected First on 68Ga-Dotatate and Then on 18F-Fluoride PET/CT(2018) DUARTE, Paulo Schiavom; MARIN, Jose Flavio Gomes; CARVALHO, Jose Willegaignon De Amorim De; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoWe report a case of a medullary thyroid carcinoma noncalcified brain metastasis characterized on Ga-68-dotatate PET/CT but not on an F-18-fluoride PET/CT performed 1 month later. Subsequent F-18-fluoride PET/CT studies performed 7 and 19 months after the Ga-68-dotatate PET/CT study demonstrated focal uptake in the metastasis. The CT images of the last PET/CT study also depicted a small focus of calcification beginning in the metastatic site.
- 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.
- Visualization of Lymph Nodal and Hepatic Metastases of Medullary Thyroid Carcinoma on F-18-Fluoride PET/CT(2015) VALE, Romulo Hermeto Bueno do; MARIN, Jose Flavio Gomes; DUARTE, Paulo Schiavom; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoF-18-fluoride uptake in soft tissue metastases has been previously described. Herein, we report a case of F-18-fluoride uptake in lymph nodal and hepatic metastases of medullary thyroid carcinoma. Simultaneous CT showed calcified lesions in these regions.
- Incidental Finding of Anterior Cranial Fossa Meningioma on F-18-Fluoride PET/CT(2013) ZACCHI, Samara Riguete; DUARTE, Paulo Schiavon; COURA FILHO, George Barberio; SAPIENZA, Marcelo Tatit; BUCHPIGUEL, Carlos AlbertoThe association of breast carcinoma and meningioma has been described. We report a case of anterior cranial fossa meningioma in a woman with breast cancer detected by F-18-fluoride PET/CT. The whole-body F-18-fluoride PET images demonstrate an intense intracranial focal radiotracer accumulation in the skull base. Simultaneous CT showed a corresponding calcified space-occupying lesion consistent with meningioma. Follow-up CT image obtained 8 months later demonstrated the persistence and stable appearance of the lesion.