Publio Viana - Academia.edu (original) (raw)
Papers by Publio Viana
Investigative Radiology, 2014
Objectives: The objective of this study was to evaluate the role of 3-T multiparametric magnetic ... more Objectives: The objective of this study was to evaluate the role of 3-T multiparametric magnetic resonance imaging (MP-MRI) and magnetic resonanceYguided biopsy (MRGB) in early risk restratification of patients on active surveillance at 3 and 12 months of follow-up. Materials and Methods: Within 4 hospitals participating in a large active surveillance trial, a side study was initiated. Pelvic magnetic resonance imaging, prostate MP-MRI, and MRGB were performed at 3 and 12 months (latter prostate MP-MRI and MRGB only) after prostate cancer diagnosis in 1 of the 4 participating hospitals. Cancer-suspicious regions (CSRs) were defined on prostate MP-MRI using Prostate Imaging Reporting And Data System (PI-RADS) scores. Risk restratification criteria for active surveillance discontinuance were (1) histopathologically proven magnetic resonance imaging suspicion of node/bone metastases and/or (2) a Gleason growth pattern (GGP) 4 and/or 5 and/or cancer multifocality (Q3 foci) in MRGB specimens of a CSR on MP-MRI. Results: From 2009 to 2012, a total of 64 of 82 patients were consecutively and prospectively included and underwent MP-MRI and a subsequent MRGB. At 3 and 12 months of follow-up, 14% (9/64) and 10% (3/30) of the patients were risk-restratified on the basis of MP-MRI and MRGB. An overall CSR PI-RADS score of 1 or 2 had a negative predictive value of 84% (38/45) for detection of any prostate cancer and 100% (45/45) for detection of a GGP 4 or 5 containing cancer upon MRGB, respectively. A CSR PI-RADS score of 4 or higher had a sensitivity of 92% (11/12) for detection of a GGP 4 or 5 containing cancer upon MRGB. Conclusions: Application of MP-MRI and MRGB in active surveillance may contribute in early identification of patients with GGP 4 or 5 containing cancers at 3 months of follow-up. If, during further follow-up, a PI-RADS score of 1 or 2 continues to have a negative predictive value for GGP 4 or 5 containing cancers, a PI-RADS standardized reported MP-MRI may be a promising tool for the selection of prostate cancer patients suitable for active surveillance.
Pulmonary nodules and metastases in non-pulmonary solid tumor bearing patients
Journal of Clinical Oncology, 2015
e17762 Background: Pulmonary nodules (PNs) in patients (pts) with non-pulmonary solid tumors pres... more e17762 Background: Pulmonary nodules (PNs) in patients (pts) with non-pulmonary solid tumors present a diagnostic challenge; comprising other possibilities than metastatic disease, such as primary ...
700 Pulmonary nodules and metastases in non-pulmonary solid tumor bearing patients
European Journal of Cancer, Sep 1, 2015
Radiologia Brasileira, Jun 1, 2004
CardioVascular and Interventional Radiology, Jan 10, 2023
Eosinophilic solid and cystic renal cell carcinoma [Editorial]: Imaging Features of a Novel Neoplasm
Urology, 2018
Computed tomography for living renal donors evaluation: the main checkpoints for an accurate report
Journal of Clinical Oncology, May 20, 2019
To determine if multiparametric MRI (mpMRI) identifies significant apical disease, thereby inform... more To determine if multiparametric MRI (mpMRI) identifies significant apical disease, thereby informing decisions regarding preservation of the membranous urethra.
RadioGraphics, May 30, 2018
Case 297
Radiology, Sep 1, 2021
History A 70-year-old man was referred to our institution with chronic obstructive urinary sympto... more History A 70-year-old man was referred to our institution with chronic obstructive urinary symptoms and constipation for 2 years before admission. His medical history was unremarkable. Outside laboratory tests revealed an elevated serum prostate-specific antigen level (21.7 ng/mL [normal range, 0.00-4.00 ng/mL]), and urinalysis results were negative. He was admitted for evaluation of possible prostate cancer. The patient reported no specific symptoms of infection and denied fever, dysuria, hematuria, and abdominal pain. He had no family history of prostate cancer. On physical examination, he was afebrile, and the digital rectal examination was not painful. These findings were evidence of an enlarged prostate and a hard multilobulated mass, which was palpable bilaterally. The urologic team performed MRI of the prostate (Figs 1-4).
Conventional and partially ECG-gated triple-rule-out computed angiotomography: Comparative radiation dose and imaging quality
Archives in Cancer Research, Sep 20, 2019
Archives in Cancer Research, Sep 20, 2019
Background: Colorectal adenocarcinoma represents the third most incident cancer. Obesity is a wor... more Background: Colorectal adenocarcinoma represents the third most incident cancer. Obesity is a world health problem that has been controversial when associated with cancer. Evaluation of VAT (visceral adipose tissue) and SAT (subcutaneous adipose tissue) as different measurements can contribute to clarify its performance. The aim is to investigate the influence of the VAT and SAT volume in patients with colorectal adenocarcinoma with and without hepatic metastasis using Computed Tomography (CT). Methods: VAT and SAT were evaluated in a retrospective way. All patients were chemo-naïve and did not pass throw surgery before the imaging analysis. The best cutoff point for categorical variables were defined by ROC curves. Chisquare test was used to evaluate the relation between presence of variables (general metastasis, hepatic metastasis, mutation in KRAS, NRAS, PIK3CA and PTEN genes) and categorical variables (SAT and BMI). Results: 64 patients with colorectal were evaluated. Negative correlations of SAT volume (≤60 cm3) and general metastasis (p=0.012), hepatic metastasis (p=0.025) and PIK3CA mutation (p=0.007) were found. In addition, patients with Body mass index (BMI) ≤27 Kg/m2 were related either to presence of general metastasis (p=0.025), hepatic metastasis (p=0.01) and PIK3CA mutation (p=0.036). Conclusion: Few SAT were related to general metastasis and hepatic metastasis, which can be confirmed with same results in BMI less than 27 Kg/m2. Moreover, the relation between PIK3CA mutation, few SAT and BMI less than 27 Kg/m2, which promote cancer cell growth, proliferation and is related to resistance to anti-EGFR therapy, foment these results. Biography Pamela Bertolazzi is a Biomedical Scientist. She has completed her Graduation in 2011 and has worked with diagnostic imaging at Sirio Libanes Hospital for seven years. Currently, she is working as a Sr. Clinical Application Specialist at Siemens Healthineers. During her time at Hospital, she was invited to teach in the first Biomedical Residence Program in Brazil. She is a PhD student with a project focused on cerebral changes of obese children in University of Sao Paulo. Her work has a great repercussion around the world and she hopes that her work will help people in the near future.
Journal of Clinical Oncology, Jun 1, 2022
Background: Patients (pts) with high-risk localized prostate cancer (HRLPC) have a significant ri... more Background: Patients (pts) with high-risk localized prostate cancer (HRLPC) have a significant risk of disease recurrence and metastasis after radical prostatectomy (RP). Neoadjuvant therapy remains investigational but there may be a role for the next-generation androgen signaling inhibitors. We sought to evaluate pathologic and imaging response after the intense neoadjuvant approach. Methods: This is a phase II investigator-initiated randomized trial of 3-month neoadjuvant therapy with goserelin (androgen deprivation therapy, ADT) + abiraterone acetate and prednisone (AAP arm) or AAP + apalutamide (A-APA arm) before RP for pts with HRLPC (Gleason ≥ 8 and/or cT3N0-1 and/or PSA ≥ 20 ng/ mL). The primary endpoint was the rate of pathologic complete response (pCR) or minimal residual disease (MRD, tumor ≤ 0.5 cm). The secondary endpoints were safety, rate of residual cancer burden ≤0.25 cm 3 (RCB = tumor volume x cellularity), Gallium 68 prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/magnetic resonance correlates and rate of biochemical relapse (BR). Results: Sixty-two pts were randomized to A-APA (N = 31) or AAP (N = 31). Median age was 65 (range 47-77) years. NCCN risk groups included high-risk disease in 19%, very high-risk in 76% and regional (N1) disease in 5% (79% cT3, 65% Gleason 8-10, 57% PSA ≥ 20 ng/mL). Outcomes after intense neoadjuvant ADT are described in the Table. There was no statistically significant difference between study arms regarding pCR/MRD or RCB ≤ 0.25 cm 3 rates. Patients with complete PSMA-PET response (psmaCR) demonstrated a RCB ≤ 0.25 cm 3 rate of 50% compared to 7.5% in pts without a psmaCR (P= 0.001). The rate of BR was 14% for pts with RCB ≤ 0.25 cm 3 versus 38% in pts with RCB > 0.25 cm 3 (P= 0.118). At current median follow-up of 2.6 years, all patients with both psmaCR and RCB ≤ 0.25cm 3 (N = 11, 18%) are free of BR. There were 2 grade (G) 5 adverse events (AEs) in the AAP arm (pulmonary embolism and sudden death, both after surgery). Nine (14.5%) pts (6 in A-APA; 3 in AAP) experienced G3-4 treatment-related AEs. The most common G3-4 AEs were hypertension (11.3%), AST/ALT elevations (3.2%) and skin rash (1.6%). Conclusions: No difference in pCR or MRD was observed between arms. Although pCR or MRD after intense neoadjuvant ADT was infrequent, a significant proportion of pts achieved a favorable pathologic response with RCB ≤ 0.25 cm 3. PSMA-PET response is a potential surrogate for pathologic response. Clinical trial information: NCT02789878. Research Sponsor: Janssen.
Application of iodine map, monoenergetic 40-kev and cinematic rendering in the diagnosis of pancreas diseases
Archives in Cancer Research, Sep 20, 2019
Medicine, Jun 19, 2020
Rationale: Immunoglobulin G4 (IgG4)-related disease is an increasingly recognized immune-mediated... more Rationale: Immunoglobulin G4 (IgG4)-related disease is an increasingly recognized immune-mediated entity that can affect virtually every organ system. Depending on the location of the disease, it can present a wide range of clinical manifestations and even mimic malignancies. Appendiceal involvement in patients with IgG4-related disease is particularly rare and very few cases are reported in the literature. Patient concerns: We report a case of IgG4-related appendiceal disease in a 42-year-old woman who presents with a subacute onset of right lower quadrant abdominal pain. Diagnosis: Abdominal computed tomography showed a markedly enlarged appendix, raising the concern of malignancy. The diagnosis of IgG4 appendiceal disease was confirmed by postoperative histopathologic and immunohistochemical examination. Interventions: The patient underwent right hemicolectomy. Outcomes: After the surgery, the patient had an uneventful recovery and reported a resolution of her symptoms. The serum IgG4 was revaluated 5 days after surgery and returned to its normal values. At the 3-year follow up, the patient had no recurrence of symptoms and her imaging exams remain unremarkable. Lessons: This study reports the fifth case of IgG4-related appendiceal disease. Increasing awareness of this condition may influence the management of these patients, once patients with IgG4-related disease should be monitored after treatment, due to the risk of recurrence or involvement of other organs.
Safety and feasibility of radiofrequency ablation for treatment of Bosniak IV renal cysts
International Braz J Urol, Jun 1, 2016
Eosinophilic Solid and Cystic Renal Cell Carcinoma: Imaging Features of a Novel Neoplasm
Urology, Apr 1, 2018
Eosinophilic solid and cystic renal cell carcinoma (ESC RCC) is a recently described entity with ... more Eosinophilic solid and cystic renal cell carcinoma (ESC RCC) is a recently described entity with distinct clinical, pathologic, and molecular features. However, the radiological aspects of ESC RCC have not been characterized. In this report, we describe the imaging findings of 2 ESC RCCs. We found 2 distinct imaging patterns that varied depending on histopathologic features (solid or cystic predominance). In conclusion, it is important to know the imaging characteristics and pathologic correlation of this novel neoplasm to increase its recognition and to improve the decision-making process.
Association of primary tumor radiomic phenotypes and outcomes in patients (pts) with metastatic renal cell clear cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CN)
Journal of Clinical Oncology, Feb 20, 2023
Journal of the Endocrine Society, Nov 1, 2022
Investigative Radiology, 2014
Objectives: The objective of this study was to evaluate the role of 3-T multiparametric magnetic ... more Objectives: The objective of this study was to evaluate the role of 3-T multiparametric magnetic resonance imaging (MP-MRI) and magnetic resonanceYguided biopsy (MRGB) in early risk restratification of patients on active surveillance at 3 and 12 months of follow-up. Materials and Methods: Within 4 hospitals participating in a large active surveillance trial, a side study was initiated. Pelvic magnetic resonance imaging, prostate MP-MRI, and MRGB were performed at 3 and 12 months (latter prostate MP-MRI and MRGB only) after prostate cancer diagnosis in 1 of the 4 participating hospitals. Cancer-suspicious regions (CSRs) were defined on prostate MP-MRI using Prostate Imaging Reporting And Data System (PI-RADS) scores. Risk restratification criteria for active surveillance discontinuance were (1) histopathologically proven magnetic resonance imaging suspicion of node/bone metastases and/or (2) a Gleason growth pattern (GGP) 4 and/or 5 and/or cancer multifocality (Q3 foci) in MRGB specimens of a CSR on MP-MRI. Results: From 2009 to 2012, a total of 64 of 82 patients were consecutively and prospectively included and underwent MP-MRI and a subsequent MRGB. At 3 and 12 months of follow-up, 14% (9/64) and 10% (3/30) of the patients were risk-restratified on the basis of MP-MRI and MRGB. An overall CSR PI-RADS score of 1 or 2 had a negative predictive value of 84% (38/45) for detection of any prostate cancer and 100% (45/45) for detection of a GGP 4 or 5 containing cancer upon MRGB, respectively. A CSR PI-RADS score of 4 or higher had a sensitivity of 92% (11/12) for detection of a GGP 4 or 5 containing cancer upon MRGB. Conclusions: Application of MP-MRI and MRGB in active surveillance may contribute in early identification of patients with GGP 4 or 5 containing cancers at 3 months of follow-up. If, during further follow-up, a PI-RADS score of 1 or 2 continues to have a negative predictive value for GGP 4 or 5 containing cancers, a PI-RADS standardized reported MP-MRI may be a promising tool for the selection of prostate cancer patients suitable for active surveillance.
Pulmonary nodules and metastases in non-pulmonary solid tumor bearing patients
Journal of Clinical Oncology, 2015
e17762 Background: Pulmonary nodules (PNs) in patients (pts) with non-pulmonary solid tumors pres... more e17762 Background: Pulmonary nodules (PNs) in patients (pts) with non-pulmonary solid tumors present a diagnostic challenge; comprising other possibilities than metastatic disease, such as primary ...
700 Pulmonary nodules and metastases in non-pulmonary solid tumor bearing patients
European Journal of Cancer, Sep 1, 2015
Radiologia Brasileira, Jun 1, 2004
CardioVascular and Interventional Radiology, Jan 10, 2023
Eosinophilic solid and cystic renal cell carcinoma [Editorial]: Imaging Features of a Novel Neoplasm
Urology, 2018
Computed tomography for living renal donors evaluation: the main checkpoints for an accurate report
Journal of Clinical Oncology, May 20, 2019
To determine if multiparametric MRI (mpMRI) identifies significant apical disease, thereby inform... more To determine if multiparametric MRI (mpMRI) identifies significant apical disease, thereby informing decisions regarding preservation of the membranous urethra.
RadioGraphics, May 30, 2018
Case 297
Radiology, Sep 1, 2021
History A 70-year-old man was referred to our institution with chronic obstructive urinary sympto... more History A 70-year-old man was referred to our institution with chronic obstructive urinary symptoms and constipation for 2 years before admission. His medical history was unremarkable. Outside laboratory tests revealed an elevated serum prostate-specific antigen level (21.7 ng/mL [normal range, 0.00-4.00 ng/mL]), and urinalysis results were negative. He was admitted for evaluation of possible prostate cancer. The patient reported no specific symptoms of infection and denied fever, dysuria, hematuria, and abdominal pain. He had no family history of prostate cancer. On physical examination, he was afebrile, and the digital rectal examination was not painful. These findings were evidence of an enlarged prostate and a hard multilobulated mass, which was palpable bilaterally. The urologic team performed MRI of the prostate (Figs 1-4).
Conventional and partially ECG-gated triple-rule-out computed angiotomography: Comparative radiation dose and imaging quality
Archives in Cancer Research, Sep 20, 2019
Archives in Cancer Research, Sep 20, 2019
Background: Colorectal adenocarcinoma represents the third most incident cancer. Obesity is a wor... more Background: Colorectal adenocarcinoma represents the third most incident cancer. Obesity is a world health problem that has been controversial when associated with cancer. Evaluation of VAT (visceral adipose tissue) and SAT (subcutaneous adipose tissue) as different measurements can contribute to clarify its performance. The aim is to investigate the influence of the VAT and SAT volume in patients with colorectal adenocarcinoma with and without hepatic metastasis using Computed Tomography (CT). Methods: VAT and SAT were evaluated in a retrospective way. All patients were chemo-naïve and did not pass throw surgery before the imaging analysis. The best cutoff point for categorical variables were defined by ROC curves. Chisquare test was used to evaluate the relation between presence of variables (general metastasis, hepatic metastasis, mutation in KRAS, NRAS, PIK3CA and PTEN genes) and categorical variables (SAT and BMI). Results: 64 patients with colorectal were evaluated. Negative correlations of SAT volume (≤60 cm3) and general metastasis (p=0.012), hepatic metastasis (p=0.025) and PIK3CA mutation (p=0.007) were found. In addition, patients with Body mass index (BMI) ≤27 Kg/m2 were related either to presence of general metastasis (p=0.025), hepatic metastasis (p=0.01) and PIK3CA mutation (p=0.036). Conclusion: Few SAT were related to general metastasis and hepatic metastasis, which can be confirmed with same results in BMI less than 27 Kg/m2. Moreover, the relation between PIK3CA mutation, few SAT and BMI less than 27 Kg/m2, which promote cancer cell growth, proliferation and is related to resistance to anti-EGFR therapy, foment these results. Biography Pamela Bertolazzi is a Biomedical Scientist. She has completed her Graduation in 2011 and has worked with diagnostic imaging at Sirio Libanes Hospital for seven years. Currently, she is working as a Sr. Clinical Application Specialist at Siemens Healthineers. During her time at Hospital, she was invited to teach in the first Biomedical Residence Program in Brazil. She is a PhD student with a project focused on cerebral changes of obese children in University of Sao Paulo. Her work has a great repercussion around the world and she hopes that her work will help people in the near future.
Journal of Clinical Oncology, Jun 1, 2022
Background: Patients (pts) with high-risk localized prostate cancer (HRLPC) have a significant ri... more Background: Patients (pts) with high-risk localized prostate cancer (HRLPC) have a significant risk of disease recurrence and metastasis after radical prostatectomy (RP). Neoadjuvant therapy remains investigational but there may be a role for the next-generation androgen signaling inhibitors. We sought to evaluate pathologic and imaging response after the intense neoadjuvant approach. Methods: This is a phase II investigator-initiated randomized trial of 3-month neoadjuvant therapy with goserelin (androgen deprivation therapy, ADT) + abiraterone acetate and prednisone (AAP arm) or AAP + apalutamide (A-APA arm) before RP for pts with HRLPC (Gleason ≥ 8 and/or cT3N0-1 and/or PSA ≥ 20 ng/ mL). The primary endpoint was the rate of pathologic complete response (pCR) or minimal residual disease (MRD, tumor ≤ 0.5 cm). The secondary endpoints were safety, rate of residual cancer burden ≤0.25 cm 3 (RCB = tumor volume x cellularity), Gallium 68 prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/magnetic resonance correlates and rate of biochemical relapse (BR). Results: Sixty-two pts were randomized to A-APA (N = 31) or AAP (N = 31). Median age was 65 (range 47-77) years. NCCN risk groups included high-risk disease in 19%, very high-risk in 76% and regional (N1) disease in 5% (79% cT3, 65% Gleason 8-10, 57% PSA ≥ 20 ng/mL). Outcomes after intense neoadjuvant ADT are described in the Table. There was no statistically significant difference between study arms regarding pCR/MRD or RCB ≤ 0.25 cm 3 rates. Patients with complete PSMA-PET response (psmaCR) demonstrated a RCB ≤ 0.25 cm 3 rate of 50% compared to 7.5% in pts without a psmaCR (P= 0.001). The rate of BR was 14% for pts with RCB ≤ 0.25 cm 3 versus 38% in pts with RCB > 0.25 cm 3 (P= 0.118). At current median follow-up of 2.6 years, all patients with both psmaCR and RCB ≤ 0.25cm 3 (N = 11, 18%) are free of BR. There were 2 grade (G) 5 adverse events (AEs) in the AAP arm (pulmonary embolism and sudden death, both after surgery). Nine (14.5%) pts (6 in A-APA; 3 in AAP) experienced G3-4 treatment-related AEs. The most common G3-4 AEs were hypertension (11.3%), AST/ALT elevations (3.2%) and skin rash (1.6%). Conclusions: No difference in pCR or MRD was observed between arms. Although pCR or MRD after intense neoadjuvant ADT was infrequent, a significant proportion of pts achieved a favorable pathologic response with RCB ≤ 0.25 cm 3. PSMA-PET response is a potential surrogate for pathologic response. Clinical trial information: NCT02789878. Research Sponsor: Janssen.
Application of iodine map, monoenergetic 40-kev and cinematic rendering in the diagnosis of pancreas diseases
Archives in Cancer Research, Sep 20, 2019
Medicine, Jun 19, 2020
Rationale: Immunoglobulin G4 (IgG4)-related disease is an increasingly recognized immune-mediated... more Rationale: Immunoglobulin G4 (IgG4)-related disease is an increasingly recognized immune-mediated entity that can affect virtually every organ system. Depending on the location of the disease, it can present a wide range of clinical manifestations and even mimic malignancies. Appendiceal involvement in patients with IgG4-related disease is particularly rare and very few cases are reported in the literature. Patient concerns: We report a case of IgG4-related appendiceal disease in a 42-year-old woman who presents with a subacute onset of right lower quadrant abdominal pain. Diagnosis: Abdominal computed tomography showed a markedly enlarged appendix, raising the concern of malignancy. The diagnosis of IgG4 appendiceal disease was confirmed by postoperative histopathologic and immunohistochemical examination. Interventions: The patient underwent right hemicolectomy. Outcomes: After the surgery, the patient had an uneventful recovery and reported a resolution of her symptoms. The serum IgG4 was revaluated 5 days after surgery and returned to its normal values. At the 3-year follow up, the patient had no recurrence of symptoms and her imaging exams remain unremarkable. Lessons: This study reports the fifth case of IgG4-related appendiceal disease. Increasing awareness of this condition may influence the management of these patients, once patients with IgG4-related disease should be monitored after treatment, due to the risk of recurrence or involvement of other organs.
Safety and feasibility of radiofrequency ablation for treatment of Bosniak IV renal cysts
International Braz J Urol, Jun 1, 2016
Eosinophilic Solid and Cystic Renal Cell Carcinoma: Imaging Features of a Novel Neoplasm
Urology, Apr 1, 2018
Eosinophilic solid and cystic renal cell carcinoma (ESC RCC) is a recently described entity with ... more Eosinophilic solid and cystic renal cell carcinoma (ESC RCC) is a recently described entity with distinct clinical, pathologic, and molecular features. However, the radiological aspects of ESC RCC have not been characterized. In this report, we describe the imaging findings of 2 ESC RCCs. We found 2 distinct imaging patterns that varied depending on histopathologic features (solid or cystic predominance). In conclusion, it is important to know the imaging characteristics and pathologic correlation of this novel neoplasm to increase its recognition and to improve the decision-making process.
Association of primary tumor radiomic phenotypes and outcomes in patients (pts) with metastatic renal cell clear cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CN)
Journal of Clinical Oncology, Feb 20, 2023
Journal of the Endocrine Society, Nov 1, 2022