肿瘤代谢的超极化 C MRI 显示乳腺癌新辅助化疗的早期代谢反应。
Hyperpolarized C MRI of Tumor Metabolism Demonstrates Early Metabolic Response to Neoadjuvant Chemotherapy in Breast Cancer.
机构信息
Departments of Radiology (R.W., A.B.G., J.T.G., A.J.P., S.U., F.Z., M.L., M.C.L., S.H., A.F., L.B., L.R., E.S., M.J.G., F.J.G., F.A.G.), Oncology (J.K., H.B., E.H., B.B., R.B., J.E.A., C.C.), and Biochemistry (K.M.B.), the Cambridge Breast Cancer Research Unit (E.P., J.K., H.B., E.H., R.B., J.E.A., C.C.), University of Cambridge, Cambridge, England; Departments of Radiology (A.J.P., I.P., R.S., M.J.G., F.J.G., F.A.G.) and Histopathology (E.P.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England; Cancer Research UK Cambridge Centre, Cambridge, England (R.W., M.A.M., E.P., T.T., L.B., L.R., E.S., J.E.A., C.C., K.M.B., F.A.G.); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria (R.W., L.B.); Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, England (M.A.M., T.T., C.C., K.M.B.); and RAPID Biomedical, Rimpar, Germany (T.L.).
出版信息
Radiol Imaging Cancer. 2020 Jul 31;2(4):e200017. doi: 10.1148/rycan.2020200017.
PURPOSE
To compare hyperpolarized carbon 13 (C) MRI with dynamic contrast material-enhanced (DCE) MRI in the detection of early treatment response in breast cancer.
MATERIALS AND METHODS
In this institutional review board-approved prospective study, a woman with triple-negative breast cancer (age, 49 years) underwent C MRI after injection of hyperpolarized [1-carbon 13 {C}]-pyruvate and DCE MRI at 3 T at baseline and after one cycle of neoadjuvant therapy. The C-labeled lactate-to-pyruvate ratio derived from hyperpolarized C MRI and the pharmacokinetic parameters transfer constant ( ) and washout parameter ( ) derived from DCE MRI were compared before and after treatment.
RESULTS
Exchange of the C label between injected hyperpolarized [1-C]-pyruvate and the endogenous lactate pool was observed, catalyzed by the enzyme lactate dehydrogenase. After one cycle of neoadjuvant chemotherapy, a 34% reduction in the C-labeled lactate-to-pyruvate ratio resulted in correct identification of the patient as a responder to therapy, which was subsequently confirmed via a complete pathologic response. However, DCE MRI showed an increase in mean (132%) and mean (31%), which could be incorrectly interpreted as a poor response to treatment.
CONCLUSION
Hyperpolarized C MRI enabled successful identification of breast cancer response after one cycle of neoadjuvant chemotherapy and may improve response prediction when used in conjunction with multiparametric proton MRI.Published under a CC BY 4.0 license.
目的
比较超极化碳 13（C）MRI 与动态对比增强（DCE）MRI 在检测乳腺癌早期治疗反应中的作用。
材料和方法
在这项经机构审查委员会批准的前瞻性研究中，一名患有三阴性乳腺癌的女性（年龄 49 岁）在基线和新辅助治疗一个周期后，于 3 T 磁共振上接受了超极化 [1-碳 13（C）]-丙酮酸注射后的 C MRI 和 DCE MRI。比较治疗前后从超极化 C MRI 获得的 C 标记的乳酸/丙酮酸比值和从 DCE MRI 获得的转移常数（）和洗脱参数（）。
结果
观察到酶乳酸脱氢酶催化下，注入的超极化[1-C]-丙酮酸与内源性乳酸池之间的 C 标记交换。新辅助化疗一个周期后，C 标记的乳酸/丙酮酸比值降低 34%，正确识别出该患者对治疗有反应，随后通过完全病理缓解得到证实。然而，DCE MRI 显示平均 （132%）和平均 （31%）增加，这可能被错误地解释为对治疗的不良反应。
结论
超极化 C MRI 能够成功识别新辅助化疗一个周期后的乳腺癌反应，并在与质子多参数 MRI 联合使用时可能改善反应预测。在 CC BY 4.0 许可下发布。
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