I am originally from San Diego, California where I attended medical school and did a surgical internship at UCSD. While there, I was exposed to the field of Nuclear Medicine and became fascinated by molecular imaging and the burgeoning field of theragnostics. I chose the Nuclear Medicine residency program at Stanford because it is one of the premier molecular imaging programs in the world, where some of the best known physicians and scientists in the field are located. Situated in Silicon Valley and rooted in a culture of collaboration, Stanford reaps the benefits from being at the intersection of technology, innovation, engineering and science to produce ground breaking research that continually pushes the imagination and limits of Nuclear Medicine. I am honored to be able to pursue my clinical interests and further my career in this environment.
- Nuclear Medicine
- Positron-Emission Tomography and Computed Tomography
- CT and SPECT
- Cardiac Gated SPECT Imaging
- Therapeutic, Radionuclides
Clinical Assistant Professor, Radiology - Rad/Nuclear Medicine
Honors & Awards
Norman D Poe Memorial Scholarship Award for MD In-Training, Western Regional Society of Nuclear Medicine meeting (October 2011)
Boards, Advisory Committees, Professional Organizations
member, Society of Nuclear Medicine (2010 - Present)
Medical Education: University of California San Diego School of Medicine (2008) CA
Board Certification: American Board of Nuclear Medicine, Nuclear Medicine (2013)
Residency: Stanford University Nuclear Medicine Residency (2013) CA
Internship: UCSD Surgery Residency (2009) CA
Study Evaluating Zr-Panitumumab for Assessment of Suspected Metastatic Lesions on 18F-FDG-PET/CT in Head and Neck Squamous Cell Carcinoma
The purpose of this study is to determine the diagnostic utility of 89Zr-panitumumab to identify metastatic lesion(s) in subjects with head and neck squamous cell carcinoma (HNSCC).
Stanford is currently not accepting patients for this trial. For more information, please contact Roan C Raymundo, BS, 650-721-4071.
Peptide Receptor Radionuclide Therapy (PRRT) in Advanced Pheochromocytoma and Paraganglioma From a Single Institution Experience
LIPPINCOTT WILLIAMS & WILKINS. 2022: E42-E43
View details for Web of Science ID 000819123700057
PROSPECTIVE EVALUATION OF F-18-DCFPYL PET/CT IN BIOCHEMICALLY RECURRENT PROSTATE CANCER: ANALYSIS OF F-18-DCFPYL UPTAKE IN POSSIBLE EXTRA-PELVIC OLIGOMETASTASES
LIPPINCOTT WILLIAMS & WILKINS. 2021: E1177-E1178
View details for Web of Science ID 000693689000847
Perfusion Only Scans with and without SPECT/CT in the Era of COVID-19
SOC NUCLEAR MEDICINE INC. 2021
View details for Web of Science ID 000713713600506
Prognostic value of bone marrow metabolism on pretreatment 18F-FDG PET/CT in patients with metastatic melanoma treated with anti-PD-1 therapy.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Purpose: To investigate the prognostic value of 18F-FDG PET/CT parameters in melanoma patients before beginning anti-PD-1 therapy. Methods: Imaging parameters including SUVmax, metabolic tumor volume (MTV), and bone marrow to liver SUVmean ratio (BLR) were measured from baseline PET/CT in 92 patients before the start of anti-PD-1 therapy. Association with survival and imaging parameters combined with clinical factors was evaluated. Clinical and laboratory data between high (> median) and low (≤ median) BLR groups were compared. Results: Multivariate analyses demonstrated that BLR was an independent prognostic factor for PFS and OS (P = 0.017, P = 0.011, respectively). The high BLR group had higher levels of white blood cell count/neutrophil count and C-Reactive Protein than the low BLR group (P < 0.05). Conclusion: Patients with high BLR were associated with poor PFS and OS, potentially explained by evidence of systemic inflammation known to be associated with immunosuppression.
View details for DOI 10.2967/jnumed.120.254482
View details for PubMedID 33547210
The Clinical Utility of 18F-Fluciclovine PET/CT in Biochemically Recurrent Prostate Cancer: an Academic Center Experience Post FDA Approval.
Molecular imaging and biology
To evaluate the diagnostic performance and clinical utility of 18F-fluciclovine PET/CT in patients with biochemical recurrence (BCR) of prostate cancer (PC).18F-Fluciclovine scans of 165 consecutive men with BCR after primary definitive treatment with prostatectomy (n = 102) or radiotherapy (n = 63) were retrospectively evaluated. Seventy patients had concurrent imaging with at least one other conventional modality (CT (n = 31), MRI (n = 31), or bone scan (n = 26)). Findings from 18F-fluciclovine PET were compared with those from conventional imaging modalities. The positivity rate and impact of 18F-fluciclovine PET on patient management were recorded. In 33 patients who underwent at least one other PET imaging (18F-NaF PET/CT (n = 12), 68Ga-PSMA11 PET/CT (n = 5), 18F-DCFPyL PET/CT (n = 20), and 68Ga-RM2 PET/MRI (n = 5)), additional findings were evaluated.The overall positivity rate of 18F-fluciclovine PET was 67 %, which, as expected, increased with higher prostate-specific antigen (PSA) levels (ng/ml): 15 % (PSA < 0.5), 50 % (0.5 ≤ PSA < 1), 56 % (1 ≤ PSA < 2), 68 % (2 ≤ PSA < 5), and 94 % (PSA ≥ 5), respectively. One hundred and two patients (62 %) had changes in clinical management based on 18F-fluciclovine PET findings. Twelve of these patients (12 %) had lesion localization on 18F-fluciclovine PET, despite negative conventional imaging. Treatment plans of 14 patients with negative 18F-fluciclovine PET were changed based on additional PET imaging with a different radiopharmaceutical.18F-Fluciclovine PET/CT remains a useful diagnostic tool in the workup of patients with BCR PC, changing clinical management in 62 % of participants in our cohort.
View details for DOI 10.1007/s11307-021-01583-3
View details for PubMedID 33469884
- Obituary for Sanjiv Sam Gambhir, MD, PhD. Clinical nuclear medicine 2020
Imaging Characteristics and Diagnostic Performance of 2-deoxy-2-[18F]fluoro-D-Glucose PET/CT for Melanoma Patients Who Demonstrate Hyperprogressive Disease When Treated with Immunotherapy.
Molecular imaging and biology
PURPOSE: We investigated the ability of baseline 2-deoxy-2-[18F]fluoro-D-glucose PET/CT parameters, acquired before the start of immunotherapy, to predict development of hyperprogressive disease (HPD) in melanoma patients. We also evaluated the diagnostic performances of ratios of baseline and first restaging PET/CT parameters to diagnose HPD without information of the tumor growth kinetic ratio (TGKR) that requires pre-baseline imaging before baseline imaging (3 timepoint imaging).PROCEDURES: Seventy-six patients who underwent PET/CT before and approximately 3months following initiation of immunotherapy were included. PET/CT parameters, including metabolic tumor volume (MTV) for all melanoma lesions and total measured tumor burden (TMTB) based on irRECIST, were measured from baseline PET/CT (MTVbase and TMTBbase) and first restaging PET/CT (MTVpost and TMTBpost). The ratios of MTV (MTVpost/MTVbase, MTVr) and TMTB (TMTBpost/TMTBbase, TMTBr) were calculated.RESULTS: MTVbase of HPD patients (n=9, TGKR ≥2) was larger than that of non-HPD (n=67, TGKR <2) patients (P<0.05), and HPD patients demonstrated shorter median overall survival (7 vs. more than 60months, P<0.05). The area under the curve (AUC) of MTVbase (≥155.5ml) to predict the risk of HPD was 0.703, with a sensitivity of 66.7% and specificity of 81.2%. The AUCs of MTVr (≥1.25) and TMTBr (≥1.27) to diagnose HPD without information of TGKR were 0.875 and 0.977 with both sensitivities of 100%, and specificities of 79% and 83.9%, respectively.CONCLUSIONS: Patients at high risk of developing HPD could not be accurately identified based on baseline PET/CT parameters. The ratios of baseline and first restaging PET/CT parameters may be helpful to diagnose HPD, when patients do not undergo pre-baseline imaging.
View details for DOI 10.1007/s11307-020-01526-4
View details for PubMedID 32789649
Imaging characteristics and diagnostic performance of F-18-FDG PET/CT for melanoma patients who demonstrate hyperprogressive disease when treated with immunotherapy
SOC NUCLEAR MEDICINE INC. 2020
View details for Web of Science ID 000568290500424
Prognostic value of volumetric PET parameters at early response evaluation in melanoma patients treated with immunotherapy
SOC NUCLEAR MEDICINE INC. 2020
View details for Web of Science ID 000568290500428
PSMA-and GRPR-targeted PET: Preliminary Results in Patients with Biochemically Recurrent Prostate Cancer
SOC NUCLEAR MEDICINE INC. 2020
View details for Web of Science ID 000568290501184
Prognostic value of volumetric PET parameters at early response evaluation in melanoma patients treated with immunotherapy.
European journal of nuclear medicine and molecular imaging
The purpose of this study was to investigate the prognostic value of whole-body metabolic tumor volume (MTV) and other metabolic tumor parameters, obtained from baseline and first restaging 18F-FDG PET/CT scans in melanoma patients treated with immune checkpoint inhibitors (ICIs).Eighty-five consecutive melanoma patients (M, 57; F, 28) treated with ICIs who underwent PET/CT scans before and approximately 3 months after the start of immunotherapy were retrospectively enrolled. Metabolic tumor parameters including MTV for all melanoma lesions were measured on each scan. A Cox proportional hazards model was used for univariate and multivariate analyses of metabolic parameters combined with known clinical prognostic factors associated with overall survival (OS). Kaplan-Meier curves for patients dichotomized based on median values of imaging parameters were generated.The median OS time in all patients was 45 months (95% CI 24-45 months). Univariate analysis demonstrated that MTV obtained from first restaging PET/CT scans (MTVpost) was the strongest prognostic factor for OS among PET/CT parameters (P < 0.0001). The median OS in patients with high MTVpost (≥ 23.44) was 16 months (95% CI 12-32 months) as compared with more than 60 months in patients with low MTVpost (< 23.44) (P = 0.0003). A multivariate model including PET/CT parameters and known clinical prognostic factors revealed that MTVpost and the presence of central nervous system lesions were independent prognostic factors for OS (P = 0.0004, 0.0167, respectively). One pseudoprogression case (1.2%) was seen in this population and classified into the high MTVpost group.Whole-body metabolic tumor volume from PET scan acquired approximately 3 months following initiation of immunotherapy (MTVpost) is a strong prognostic indicator of OS in melanoma patients. Although the possibility of pseudoprogression must be considered whenever evaluating first restaging PET imaging, it only occurred in 1 patient in our cohort.
View details for DOI 10.1007/s00259-020-04792-0
View details for PubMedID 32296882
Review of utilization of surveillance scans in lymphoma patients: A pilot study
SOC NUCLEAR MEDICINE INC. 2011
View details for Web of Science ID 000443798901492
- Ultrasound Evaluation of Regional Breast Lymph Nodes SEMINARS IN ROENTGENOLOGY 2011; 46 (1): 51-59
How to improve your breast cancer program: Standardized reporting using the new American College of Radiology Breast Imaging-Reporting and Data System.
The Indian journal of radiology & imaging
2009; 19 (4): 266-77
In the USA, the use of the American College of Radiology Breast Imaging-Reporting and Data System (ACR BI-RADS) has served not only as a quality assurance tool and guide to standardizing breast imaging reports but has also improved communication between referring physicians, researchers, and patients. In fact, in the USA, the Mammography Quality Standards Act of 1997 requires that all mammograms be assigned a BI-RADS category based on the finding of most concern. In this manuscript, we aim to review the recommendations provided in the 4 th edition of the ACR BI-RADS for mammography, USG, and MRI. We also review the major controversies surrounding the use of ACR BI-RADS .
View details for DOI 10.4103/0971-3026.57206
View details for PubMedID 19881101
View details for PubMedCentralID PMC2797737
Early degradation and serum appearance of type I collagen fragments after myocardial infarction
JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY
2004; 36 (4): 597-601
Although extracellular matrix-degrading enzymes matrix metalloproteinases (MMPs) are activated within minutes after myocardial infarction (MI), the time course of early MI-induced type I cardiac collagen degradation has not been assessed, nor has the ability of MMP inhibitor compounds, such as doxycycline (DOX), to limit these events. The objective of this study was to assess serum biomarker evidence of myocardial type I collagen degradation early (<48 h) after coronary occlusion (CO) and determine the capacity of DOX to ameliorate its release. CO studies were performed in untreated and DOX pre-treated pigs. Treated animals received DOX at 30 mg/kg/d. Radioimmunoassays were performed for serum levels of C-terminal telopeptide of collagen type I (ICTP) fragments. ICTP groups peaked by 6 h after MI. However, in DOX-treated animals, ICTP values returned to normal by 8 h. Average serum concentrations for ICTP values from 0 to 48 h post-MI were significantly inhibited by DOX treatment. In conclusion, serum biomarker results indicate that type I collagen degradation occurs within minutes after MI and that DOX likely reduces its degradation.
View details for DOI 10.1016/j.yjmcc.2004.01.004
View details for Web of Science ID 000221181400015
View details for PubMedID 15081319
Early short-term treatment with doxycycline modulates postinfarction left ventricular remodeling
2003; 108 (12): 1487-1492
Myocardial infarction (MI) is associated with early metalloproteinase (MMP) activation and extracellular matrix (ECM) degradation. We hypothesized that preserving the original ECM of the infarcted left ventricle (LV) by use of early short-term doxycycline (DOX) treatment preserves cardiac structure and function.LV morphometry and function were measured in 3 groups of rats (sham, MI, and MI+DOX). DOX (30 mg/kg per day) was given orally 48 hours before and 48 hours after MI. Rats were examined at 2 and 4 weeks after MI. By 4 weeks, DOX significantly decreased (P<0.05 versus MI) the heart weight to body weight ratio, myocyte cross-sectional area, and internal LV diameter, whereas it preserved anterior wall thickness within the infarct. Collagen/muscle area fraction did not change in the region of the infarct/scar. Parallel left shifts (versus MI) were observed in pressure-volume relationships of DOX MI rats at all pressures. DOX treatment also shifted passive epicardial strains within the scar area toward normal values. No differences were observed in LV end-diastolic or peak systolic pressures, peak positive or negative LV dP/dt, or isovolumic relaxation rates. Assessment of LV global MMP and MMP-2/9 activities 1 hour after MI using fluorescent probes yielded significant differences with DOX.Brief, early MMP inhibition after MI yields preservation of LV structure and global as well as scar area passive function, supporting the concept that preserving the original ECM early after coronary occlusion lessens ventricular remodeling.
View details for DOI 10.1161/01.CIR.0000089090.05757.34
View details for Web of Science ID 000185467400014
View details for PubMedID 12952845