University of California San Francisco
Helen Diller Family Comprehensive Cancer Center
Robert Flavell, MD, PhD

Robert Flavell, MD, PhD

Assistant Professor in Residence, Department of Radiology and Biomedical Imaging, UCSF

Cancer Center Program Memberships

Prostate Cancer

Research Summary

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.

Education

Wesleyan University, Middletown, CT, B.A., 1996-2000, Mathematics and chemistry
The Rockefeller University, New York, NY, laboratory of Dr. Tom W. Muir, PhD, 2002 - 2010, Peptide and protein chemistry, radiolabeling methods, and PET imaging
Weill Cornell Medical College, New York, NY, MD, 2002 - 2010, Medicine
Memorial Sloan-Kettering Cancer Center, 2010 - 2011, Transitional year intern
Dept of Radiology, UCSF Medical Center, San Francisco, CA, 2011 - 2015, Diagnostic radiology residency
Dept of Radiology, UCSF Medical Center, San Francisco, CA 2015 - 2016, Nuclear medicine fellowship


Professional Experience

  • 2000 - 2002
    Research Assistant, Laboratory of Synthetic Protein Chemistry, Rockefeller University
  • 2016 – present
    Assistant Professor in Residence, Department of Radiology and Biomedical Imaging, University of California, San Francisco

Honors & Awards

  • 2000
    Honors for undergraduate thesis in chemistry, Wesleyan University, Middletown, CT
  • 2013
    Introduction to Academic Radiology Program, American Roentgen Ray Society
  • 2014
    Certificate of Merit, 2014 Radiology Society of North America meeting
  • 2014
    University of California, San Francisco catalyst program consultation award
  • 2015
    Radiology Society of North America, Roentgen Resident Research award
  • 2015
    Association of University Radiologists Research Scholar Program
  • 2015
    Certificate of Merit, 2015 Radiology Society of North America Meeting
  • 2016
    Runner up, Surbeck Scholar’s Award, University of California, San Francisco

Selected Publications

  1. Wang S, Blaha C, Santos R, Huynh T, Hayes TR, Beckford Vera DR, Blecha JE, Hong AS, Fogarty M, Hope TA, Raleigh DR, Wilson DM, Evans MJ, VanBrocklin HF, Ozawa T, Flavell RR. Synthesis and initial biological evaluation of boron-containing prostate specific membrane antigen ligands for treatment of prostate cancer using boron neutron capture therapy. Mol Pharm. 2019 Aug 05.
    View on PubMed
  2. Wang S, Korenchan DE, Perez PM, Taglang C, Hayes TR, Sriram R, Bok R, Hong AS, Wu Y, Li H, Wang Z, Kurhanewicz J, Wilson D, Flavell R. Amino Acid-Derived Sensors For Specific Zn2+ Detection Using Hyperpolarized 13C Magnetic Resonance Spectroscopy. Chemistry. 2019 Jul 23.
    View on PubMed
  3. Korenchan DE, Flavell RR. Spatiotemporal pH Heterogeneity as a Promoter of Cancer Progression and Therapeutic Resistance. Cancers (Basel). 2019 Jul 20; 11(7).
    View on PubMed
  4. Korenchan DE, Gordon JW, Subramaniam S, Sriram R, Baligand C, VanCriekinge M, Bok R, Vigneron DB, Wilson DM, Larson PEZ, Kurhanewicz J, Flavell RR. Using bidirectional chemical exchange for improved hyperpolarized [13 C]bicarbonate pH imaging. Magn Reson Med. 2019 Sep; 82(3):959-972.
    View on PubMed
  5. Raghavan K, Wen KW, Small EJ, Ha P, Flavell RR. Incidentally Detected Oropharyngeal Squamous Cell Carcinoma on 18F-Fluciclovine PET/CT. Clin Nucl Med. 2019 May; 44(5):e367-e369.
    View on PubMed
  6. Lawhn-Heath C, Flavell RR, Behr SC, Yohannan T, Greene KL, Feng F, Carroll PR, Hope TA. Single-Center Prospective Evaluation of 68Ga-PSMA-11 PET in Biochemical Recurrence of Prostate Cancer. AJR Am J Roentgenol. 2019 Apr 30; 1-8.
    View on PubMed
  7. Seo Y, Khalighi MM, Wangerin KA, Deller TW, Wang YH, Jivan S, Kohi MP, Aggarwal R, Flavell RR, Behr SC, Evans MJ. Quantitative and Qualitative Improvement of Low-Count [68Ga]Citrate and [90Y]Microspheres PET Image Reconstructions Using Block Sequential Regularized Expectation Maximization Algorithm. Mol Imaging Biol. 2019 Apr 15.
    View on PubMed
  8. Fendler WP, Calais J, Eiber M, Flavell RR, Mishoe A, Feng FY, Nguyen HG, Reiter RE, Rettig MB, Okamoto S, Emmett L, Zacho HD, Ilhan H, Wetter A, Rischpler C, Schoder H, Burger IA, Gartmann J, Smith R, Small EJ, Slavik R, Carroll PR, Herrmann K, Czernin J, Hope TA. Assessment of 68Ga-PSMA-11 PET Accuracy in Localizing Recurrent Prostate Cancer: A Prospective Single-Arm Clinical Trial. JAMA Oncol. 2019 Mar 28.
    View on PubMed
  9. Perez PM, Flavell RR, Kelley RK, Umetsu S, Behr SC. Heterogeneous Uptake of 18F-FDG and 68Ga-PSMA-11 in Hepatocellular Carcinoma. Clin Nucl Med. 2019 Mar; 44(3):e133-e135.
    View on PubMed
  10. Bok R, Lee J, Sriram R, Keshari K, Sukumar S, Daneshmandi S, Korenchan DE, Flavell RR, Vigneron DB, Kurhanewicz J, Seth P. The Role of Lactate Metabolism in Prostate Cancer Progression and Metastases Revealed by Dual-Agent Hyperpolarized 13C MRSI. Cancers (Basel). 2019 Feb 22; 11(2).
    View on PubMed
  11. Perez PM, Hope TA, Behr SC, van Zante A, Small EJ, Flavell RR. Intertumoral Heterogeneity of 18F-FDG and 68Ga-PSMA Uptake in Prostate Cancer Pulmonary Metastases. Clin Nucl Med. 2019 Jan; 44(1):e28-e32.
    View on PubMed
  12. Behr SC, Aggarwal R, Van Brocklin HF, Flavell RR, Geo K, Small EJ, Blecha J, Jivan S, Hope TA, Simko JP, Kurhanewicz J, Noworolski SM, Korn NJ, De Los Santos R, Cooperberg MR, Carroll PR, Nguyen HG, Greene KL, Langton-Webster B, Berkman CE, Seo Y. First-in-Human Phase I study of CTT1057, a Novel 18F Labeled Imaging Agent with Phosphoramidate Core Targeting Prostate Specific Membrane Antigen in Prostate Cancer. J Nucl Med. 2018 Nov 21.
    View on PubMed
  13. Ding Y, Sohn JH, Kawczynski MG, Trivedi H, Harnish R, Jenkins NW, Lituiev D, Copeland TP, Aboian MS, Mari Aparici C, Behr SC, Flavell RR, Huang SY, Zalocusky KA, Nardo L, Seo Y, Hawkins RA, Hernandez Pampaloni M, Hadley D, Franc BL. A Deep Learning Model to Predict a Diagnosis of Alzheimer Disease by Using 18F-FDG PET of the Brain. Radiology. 2019 Feb; 290(2):456-464.
    View on PubMed
  14. Villanueva-Meyer JE, Magill ST, Lee JC, Umetsu SE, Flavell RR. Detection of Metastatic Meningioma to the Liver Using 68Ga-DOTA-Octreotate PET/CT. Clin Nucl Med. 2018 Sep; 43(9):e338-e340.
    View on PubMed
  15. Qin H, Carroll VN, Sriram R, Villanueva-Meyer JE, von Morze C, Wang ZJ, Mutch CA, Keshari KR, Flavell RR, 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.
    View on PubMed
  16. 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 RR. Late-stage deuteration of 13C-enriched substrates for T1 prolongation in hyperpolarized 13C MRI. Chem Commun (Camb). 2018 May 17; 54(41):5233-5236.
    View on PubMed
  17. 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 07 13; 4(7):1067-1072.
    View on PubMed
  18. Ng QKT, Sethi P, Saunders TA, Pampaloni MH, Flavell RR. Discordant Findings on 18F-NaF and 99mTc-HDP Bone Scans in a Patient With ATTR Cardiac Amyloidosis. Clin Nucl Med. 2018 Mar; 43(3):e89-e92.
    View on PubMed
  19. Pittman S, Sethi P, Flavell RR, Pampaloni MH. Cardiac Fibroma: An Uncommon Cause of a Fixed Defect on Myocardial Perfusion Imaging. Clin Nucl Med. 2018 Feb; 43(2):e56-e58.
    View on PubMed
  20. von Morze C, Ohliger MA, Marco-Rius I, Wilson DM, Flavell RR, Pearce D, Vigneron DB, Kurhanewicz J, Wang ZJ. Direct assessment of renal mitochondrial redox state using hyperpolarized 13 C-acetoacetate. Magn Reson Med. 2018 04; 79(4):1862-1869.
    View on PubMed

Go to UCSF Profiles, powered by CTSI