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 13C 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.
Proceedings of the National Academy of Sciences of the United States of America. 2023 Nov 27 [Epub]
Nikita Sushentsev, Gregory Hamm, Jack Richings, Mary A McLean, Ines Horvat Menih, Vinay Ayyappan, Ian G Mills, Anne Y Warren, Vincent J Gnanapragasam, Simon T Barry, Richard J A Goodwin, Ferdia A Gallagher, Tristan Barrett
Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, CB2 0QQ Cambridge, United Kingdom., Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, Research & Development, AstraZeneca, Cambridge CB2 0AA, United Kingdom., Patrick G. Johnston Centre for Cancer Research, Genito-Urinary and Prostate Focus Group, Queen's University Belfast, Belfast BT9 7AE, United Kingdom., Department of Pathology, Cambridge University Hospitals National Health Service Foundation Trust, CB2 0QQ Cambridge, United Kingdom., Department of Urology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge CB2 0QQ, United Kingdom., Bioscience, Discovery, Oncology Research & Development, AstraZeneca, Cambridge CB20AA, United Kingdom.