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Robert Flavell, MD, PhD

TitleAssistant Professor
InstitutionUniversity of California San Francisco
DepartmentRadiology
Address185 Berry Street Bldg B
San Francisco CA 94158
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    Collapse Biography 
    Collapse Awards and Honors
    Society of Abdominal Radiology2017  - 2019Howard S. Stern Research Award
    University of California, San Francisco2017New Directions in Prostate Cancer Research Award
    Prostate Cancer Foundation2017  - 2020David Blitzer Young Investigator Award
    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 Research 
    Collapse Research Activities and Funding
    Application of hyperpolarized 13C interstitial pH imaging to risk stratification in prostate cancer
    NIH/NIBIB R21EB026012May 1, 2018 - Jan 31, 2021
    Role: Principal Investigator

    Collapse ORNG Applications 
    Collapse Websites

    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.
    List All   |   Timeline
    1. Qin H, Carroll VN, Sriram R, Villanueva-Meyer JE, von Morze C, Wang ZJ, Mutch CA, Keshari KR, Flavell R, Kurhanewicz J, Wilson DM. Imaging glutathione depletion in the rat brain using ascorbate-derived hyperpolarized MR and PET probes. Sci Rep. 2018 May 21; 8(1):7928. PMID: 29786697.
      View in: PubMed
    2. Taglang C, Korenchan DE, von Morze C, Yu J, Najac C, Wang S, Blecha JE, Subramaniam S, Bok R, VanBrocklin HF, Vigneron DB, Ronen SM, Sriram R, Kurhanewicz J, Wilson DM, Flavell R. Late-stage deuteration of 13C-enriched substrates for T1 prolongation in hyperpolarized 13C MRI. Chem Commun (Camb). 2018 May 17; 54(41):5233-5236. PMID: 29726563.
      View in: PubMed
    3. Mutch CA, Ordonez AA, Qin H, Parker M, Bambarger LE, Villanueva-Meyer JE, Blecha J, Carroll V, Taglang C, Flavell R, Sriram R, VanBrocklin H, Rosenberg O, Ohliger MA, Jain SK, Neumann KD, Wilson DM. [11C]Para-Aminobenzoic Acid: A Positron Emission Tomography Tracer Targeting Bacteria-Specific Metabolism. ACS Infect Dis. 2018 May 08. PMID: 29712422.
      View in: PubMed
    4. Pittman S, Sethi P, Flavell R, Pampaloni MH. Cardiac Fibroma: An Uncommon Cause of a Fixed Defect on Myocardial Perfusion Imaging. Clin Nucl Med. 2018 Feb; 43(2):e56-e58. PMID: 29215416.
      View in: PubMed
    5. von Morze C, Ohliger MA, Marco-Rius I, Wilson DM, Flavell R, Pearce D, Vigneron DB, Kurhanewicz J, Wang ZJ. Direct assessment of renal mitochondrial redox state using hyperpolarized 13 C-acetoacetate. Magn Reson Med. 2018 Apr; 79(4):1862-1869. PMID: 29314217.
      View in: PubMed
    6. Ng QKT, Sethi P, Saunders TA, Pampaloni MH, Flavell R. Discordant Findings on 18F-NaF and 99mTc-HDP Bone Scans in a Patient With ATTR Cardiac Amyloidosis. Clin Nucl Med. 2017 Dec 19. PMID: 29261619.
      View in: PubMed
    7. Pittman S, Sethi P, Flavell R, De Marco T, Hernandez Pampaloni M. Abnormal pulmonary 18F-florbetapir uptake in a patient evaluated for recurrent cardiac amyloidosis following orthotopic heart transplant. J Nucl Cardiol. 2017 Nov 03. PMID: 29101671.
      View in: PubMed
    8. Neumann KD, Villanueva-Meyer JE, Mutch CA, Flavell R, Blecha JE, Kwak T, Sriram R, VanBrocklin HF, Rosenberg OS, Ohliger MA, Wilson DM. Imaging Active Infection in vivo Using D-Amino Acid Derived PET Radiotracers. Sci Rep. 2017 Aug 11; 7(1):7903. PMID: 28801560.
      View in: PubMed
    9. Neumann K, Flavell R, Wilson DM. Exploring Metabolism In Vivo Using Endogenous 11C Metabolic Tracers. Semin Nucl Med. 2017 Sep; 47(5):461-473. PMID: 28826521.
      View in: PubMed
    10. Salimy MS, Parwani PJ, Mukai K, Pampaloni MH, Flavell R. Abnormal 18F-FDG and 82Rb PET Findings in Chagas Heart Disease. Clin Nucl Med. 2017 May; 42(5):e265-e268. PMID: 28263213.
      View in: PubMed
    11. Lawhn-Heath C, Flavell R, Glastonbury C, Hope TA, Behr SC. Incidental Detection of Head and Neck Squamous Cell Carcinoma on 68Ga-PSMA-11 PET/CT. Clin Nucl Med. 2017 Apr; 42(4):e218-e220. PMID: 28166149.
      View in: PubMed
    12. Behr SC, Mollard BJ, Yang J, Flavell R, Hawkins RA, Seo Y. Effect of Time-of-Flight and Regularized Reconstructions on Quantitative Measurements and Qualitative Assessments in Newly Diagnosed Prostate Cancer With 18F-Fluorocholine Dual Time Point PET/MRI. Mol Imaging. 2017 Jan-Dec; 16:1536012117736703. PMID: 29169313.
      View in: PubMed
    13. Flavell R, 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
    14. Flavell R, Naeger DM, Aparici CM, 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; PMCID: PMC4801421 [Available on 01/01/17].
    15. Flavell R, 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; PMCID: PMC4854293.
    16. Flavell R, 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; PMCID: PMC4854286.
    17. Mabray MC, Behr SC, Naeger DM, Flavell R, 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].
    18. Flavell R, 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.
    19. Flavell R, 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
    20. Ceccarini G, Flavell R, 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.
    21. Flavell R, 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
    22. Flavell R, 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
    23. Flavell R, 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