Beer Lucian, Bura Vlad, Ursprung Stephan, Woitek Ramona, McLean Mary A, Ang Joo Ern, Jimenez-Linan Mercedes, Gill Andrew B, Kaggie Joshua, Locke Matthew, Frary Amy, Field-Rayner Johanna, Patterson Ilse, Reinius Marika, Graves Martin J, Deen Surrin, Funingana Gabriel, Rundo Leonardo, Priest Andrew, Aloj Luigi, Manavaki Roido, Mendichovszky Iosif A, Robb Fraser, Schulte Rolf F, Couturier Dominique-Laurent, D'Santos Clive S, Franklin Valar, Kishore Kamal, Allajbeu Iris, Sauer Carolin, Gallagher Ferdia A, Brindle Kevin M, Brenton James D, Sala Evis
Department of Radiology and Cancer Research UK Cambridge Center, Cambridge, CB2 0QQ, UK.
Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, 1090, Vienna, Austria.
EJNMMI Res. 2025 Apr 17;15(1):40. doi: 10.1186/s13550-025-01219-5.
To evaluate the capability of hyperpolarized [1-C] pyruvate MRI to predict pathologic response to neoadjuvant treatment in multi-site abdominopelvic disease of high-grade serous ovarian cancer (HGSOC) patients and to compare C MRI and [F]-FDG PET/CT measurements for detecting early treatment response. We recruited eight patients with HGSOC in this prospective study who underwent C MRI and [F]-FDG PET/CT before and after the first cycle of neoadjuvant chemotherapy treatment (NACT). Imaging parameters were compared with clinical and histophatologic parameters.
We demonstrate here that C MRI of hyperpolarized [1-C]pyruvate metabolism in multiple abdominal metastases resulted in rapid labeling of the endogenous tumor lactate pool. The rate of labeling was similar between the different anatomical disease sites and independent of tumor volume. The apparent rate constant describing exchange of C label between pyruvate and lactate (k) was positively correlated with PET standard uptake values (SUV) for [F]-FDG in metastatic tumor deposits in the ovary/pelvis (R = 0.471, P = 0.02). Decreased lactate labeling could be detected after the first cycle of neoadjuvant chemotherapy and was associated with pathological response. There was no overall decrease in lactate labeling in a single patient who lacked a complete histopathologic response. k was associated with cancer tissue LDHA concentration (rho = 0.641; P = 0.02).
This exploratory study demonstrates the potential of C MRI measurements for assessing early response to neoadjuvant chemotherapy in patients with HGSOC.
评估超极化[1-C]丙酮酸磁共振成像（MRI）预测高级别浆液性卵巢癌（HGSOC）患者多部位腹盆腔疾病对新辅助治疗的病理反应的能力，并比较13C MRI和[18F]-氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（PET/CT）检测早期治疗反应的情况。在这项前瞻性研究中，我们招募了8例HGSOC患者，他们在新辅助化疗（NACT）的第一个周期前后接受了13C MRI和[18F]-FDG PET/CT检查。将影像参数与临床和组织病理学参数进行比较。
我们在此证明，多个腹部转移灶中超极化[1-C]丙酮酸代谢的13C MRI导致内源性肿瘤乳酸池快速标记。不同解剖学疾病部位之间的标记率相似，且与肿瘤体积无关。描述丙酮酸和乳酸之间13C标记交换的表观速率常数（k）与卵巢/盆腔转移瘤灶中[18F]-FDG的PET标准摄取值（SUV）呈正相关（R = 0.471，P = 0.02）。在新辅助化疗的第一个周期后可检测到乳酸标记减少，且与病理反应相关。在一名缺乏完全组织病理学反应的患者中，乳酸标记没有整体下降。k与癌组织乳酸脱氢酶A（LDHA）浓度相关（rho = 0.641；P = 0.02）。
这项探索性研究证明了13C MRI测量在评估HGSOC患者对新辅助化疗的早期反应方面的潜力。
