Imaging tumor lactate is feasible for identifying intermediate-risk prostate cancer patients with postsurgical biochemical recurrence.
Nikita SushentsevGregory HammJack RichingsMary A McLeanInes Horvat MenihVinay AyyappanIan Geoffrey MillsAnne Y WarrenVincent J GnanapragasamSimon T BarryRichard J A GoodwinFerdia A GallagherTristan BarrettPublished in: Proceedings of the National Academy of Sciences of the United States of America (2023)
While radical prostatectomy remains the mainstay of prostate cancer (PCa) treatment, 20 to 40% of patients develop postsurgical biochemical recurrence (BCR). A particularly challenging clinical cohort includes patients with intermediate-risk disease whose risk stratification would benefit from advanced approaches that complement standard-of-care diagnostic tools. Here, we show that imaging tumor lactate using hyperpolarized 13 C MRI and spatial metabolomics identifies BCR-positive patients in two prospective intermediate-risk surgical cohorts. Supported by spatially resolved tissue analysis of established glycolytic biomarkers, this study provides the rationale for multicenter trials of tumor metabolic imaging as an auxiliary tool to support PCa treatment decision-making.
Keyphrases
- prostate cancer
- radical prostatectomy
- end stage renal disease
- high resolution
- ejection fraction
- newly diagnosed
- chronic kidney disease
- decision making
- acute lymphoblastic leukemia
- palliative care
- clinical trial
- magnetic resonance imaging
- mass spectrometry
- gene expression
- magnetic resonance
- computed tomography
- quality improvement
- tyrosine kinase
- cross sectional
- patient reported
- free survival