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    Robert Flavell, MD, PhD

    TitleAssistant Professor
    SchoolUCSF School of Medicine
    DepartmentRadiology
    AddressWharf St. Building
    San Francisco CA 94158
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      Collapse Biography 
      Collapse Awards and Honors
      Department of Defense Prostate Cancer 2016Research Program Physician Research Training Grant
      University of California, San Francisco 2016Runner up, Surbeck Scholar Award
      Radiology Society of North America (RSNA) 2015Certificate of Merit
      Association of University Radiologists / American College of Radiology 2015Research Scholar Program
      Radiology Society of North America (RSNA) 2014Certificate of Merit
      University of California, San Francisco Catalyst Program 2014Catalyst Consultation Award
      National Institute of Biomedical Imaging and Bioengineering (NIBIB)2014T32 Training Grant
      American Roentgen Ray Society2013Introduction to Academic Radiology Program

      Collapse Overview 
      Collapse Overview
      Robert Flavell, MD, PhD, is an Assistant Professor in the Nuclear Medicine subspecialty in the Department of Radiology and Biomedical Imaging at the University of California, San Francisco. He received his medical degree from Weill Cornell Medical College, and his PhD from the Rockefeller University as part of the Tri-Institutional MD PhD program. He completed his one-year internship at the Memorial Sloan­Kettering Cancer Center in New York. Dr. Flavell completed a four-year diagnostic radiology residency at the University of California, San Francisco, where he also finished a Nuclear Medicine fellowship. In June 2016. he joined the faculty as an Assistant Professor in Residence.

      Dr. Flavell’s laboratory focuses on the development of new molecular imaging tools for better understanding of disease progression in patients with prostate and other cancers. One area of interest is the relationship between acidic interstitial pH and disease progression. Solid tumors are poorly perfused and secrete acids into the adjacent interstitium, resulting in a pH which is mildly acidic, typically ranging from 6.5 – 7.0. This property has been associated with high-grade malignancy, local invasion, and metastasis in animal models. Therefore, it would be desirable to have a method which could be used in patients for monitoring tissue pH. Therefore, one focus of Dr. Flavell’s research is developing methods of imaging acidic interstitial pH with potential for clinical translation. Specifically, two methods are being developed, one of which permits whole body evaluation of areas of acidic pH using positron emission tomography (PET) imaging, and one method which permits quantitative, local determination of interstitial pH based on hyperpolarized 13C magnetic resonance spectroscopy (HP-MRS). The PET method is based on pro-drug glycosylamine derivatives of the commonly used oncologic tracer, [18F]FDG, termed [18F]FDG amines, which are blocked with an acid-labile protecting group. When exposed to the mildly acidic pH present in the interstitium of a solid tumor, the caging group decomposes, liberating native [18F]FDG, which is subsequently absorbed by the adjacent cancer cell (Flavell R.R. et al., Bioconjugate Chem., 2016). The HP-MRS method is based on the administration of a 13C labeled probe which has a predictable change in its chemical shift based on pH. By comparison to a standard curve, quantitative pH measurements can be obtained (Flavell R.R. et al. Chem. Comm. 2015). These techniques are being optimized and ongoing directions include application in animal models, with the long term goal of clinical translation. Other areas of developing interest in the laboratory include techniques for imaging of metals in the microenvironment, and imaging of a metabolic signature associated with immune activation.

      Expertise:
      Nuclear Medicine

      Specialty:
      Novel radiotracer development, oncologic imaging, PET imaging, hyperpolarized 13C magnetic resonance imaging

      Professional Interests:
      Radiology, molecular imaging, PET imaging, prostate cancer, nuclear medicine, radiochemistry, hyperpolarized 13C magnetic resonance imaging

      Education and Training:
      • Medical School: Weill Cornell Medical College, New York
      • PhD: The Rockefeller University, New York
      • Internship: Memorial Sloan­-Kettering Cancer Center, New York
      • Residency: University of California, San Francisco
      • Fellowship: University of California, San Francisco – Nuclear Medicine


      Collapse Bibliographic 
      Collapse Publications
      Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
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      1. Flavell RR, Behr SC, Mabray MC, Hernandez-Pampaloni M, Naeger DM. Detecting Pulmonary Nodules in Lung Cancer Patients Using Whole Body FDG PET/CT, High-resolution Lung Reformat of FDG PET/CT, or Diagnostic Breath Hold Chest CT. Acad Radiol. 2016 Sep; 23(9):1123-9. PMID: 27283073.
        View in: PubMed
      2. Carroll VN, Truillet C, Shen B, Flavell RR, Shao X, Evans MJ, VanBrocklin HF, Scott PJ, Chin FT, Wilson DM. [(11)C]Ascorbic and [(11)C]dehydroascorbic acid, an endogenous redox pair for sensing reactive oxygen species using positron emission tomography. Chem Commun (Camb). 2016 Apr 7; 52(27):4888-90. PMID: 26963495.
        View in: PubMed
      3. Korenchan DE, Flavell RR, Baligand C, Sriram R, Neumann K, Sukumar S, VanBrocklin H, Vigneron DB, Wilson DM, Kurhanewicz J. Dynamic nuclear polarization of biocompatible (13)C-enriched carbonates for in vivo pH imaging. Chem Commun (Camb). 2016 Feb 9; 52(14):3030-3. PMID: 26792559.
        View in: PubMed
      4. Flavell RR, Naeger DM, Mari Aparici C, Hawkins RA, Pampaloni MH, Behr SC. Malignancies with Low Fluorodeoxyglucose Uptake at PET/CT: Pitfalls and Prognostic Importance: Resident and Fellow Education Feature. Radiographics. 2016 Jan-Feb; 36(1):293-4. PMID: 26761542.
        View in: PubMed
      5. Flavell RR, Truillet C, Regan MK, Ganguly T, Blecha JE, Kurhanewicz J, VanBrocklin HF, Keshari KR, Chang CJ, Evans MJ, Wilson DM. Caged [(18)F]FDG Glycosylamines for Imaging Acidic Tumor Microenvironments Using Positron Emission Tomography. Bioconjug Chem. 2016 Jan 20; 27(1):170-8. PMID: 26649808.
        View in: PubMed
      6. Flavell RR, von Morze C, Blecha JE, Korenchan DE, Van Criekinge M, Sriram R, Gordon JW, Chen HY, Subramaniam S, Bok RA, Wang ZJ, Vigneron DB, Larson PE, Kurhanewicz J, Wilson DM. Application of Good's buffers to pH imaging using hyperpolarized (13)C MRI. Chem Commun (Camb). 2015 Sep 25; 51(74):14119-22. PMID: 26257040.
        View in: PubMed
      7. Mabray MC, Behr SC, Naeger DM, Flavell RR, Glastonbury CM. Predictors of pathologic outcome of focal FDG uptake in the parotid gland identified on whole-body FDG PET imaging. Clin Imaging. 2015 Nov-Dec; 39(6):1073-9. PMID: 26324219; PMCID: PMC4630158 [Available on 11/01/16].
      8. Flavell RR, Westphalen AC, Liang C, Sotto CC, Noworolski SM, Vigneron DB, Wang ZJ, Kurhanewicz J. Abnormal findings on multiparametric prostate magnetic resonance imaging predict subsequent biopsy upgrade in patients with low risk prostate cancer managed with active surveillance. Abdom Imaging. 2014 Oct; 39(5):1027-35. PMID: 24740760; PMCID: PMC4169752.
      9. Flavell RR, Behr SC, Brunsing RL, Naeger DM, Pampaloni MH. The incidence of pulmonary embolism and associated FDG-PET findings in IV contrast-enhanced PET/CT. Acad Radiol. 2014 Jun; 21(6):718-25. PMID: 24809314.
        View in: PubMed
      10. Ceccarini G, Flavell RR, Butelman ER, Synan M, Willnow TE, Bar-Dagan M, Goldsmith SJ, Kreek MJ, Kothari P, Vallabhajosula S, Muir TW, Friedman JM. PET imaging of leptin biodistribution and metabolism in rodents and primates. Cell Metab. 2009 Aug; 10(2):148-59. PMID: 19656493; PMCID: PMC2867490.
      11. Flavell RR, Muir TW. Expressed protein ligation (EPL) in the study of signal transduction, ion conduction, and chromatin biology. Acc Chem Res. 2009 Jan 20; 42(1):107-16. PMID: 18939858.
        View in: PubMed
      12. Flavell RR, Kothari P, Bar-Dagan M, Synan M, Vallabhajosula S, Friedman JM, Muir TW, Ceccarini G. Site-specific (18)F-labeling of the protein hormone leptin using a general two-step ligation procedure. J Am Chem Soc. 2008 Jul 16; 130(28):9106-12. PMID: 18570424.
        View in: PubMed
      13. Flavell RR, Huse M, Goger M, Trester-Zedlitz M, Kuriyan J, Muir TW. Efficient semisynthesis of a tetraphosphorylated analogue of the Type I TGFbeta receptor. Org Lett. 2002 Jan 24; 4(2):165-8. PMID: 11796041.
        View in: PubMed
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