This project developed a new approach of integrating research biopsy targets, defined by metabolic abnormalities on hyperpolarized (HP) 13C pyruvate MRI, into clinical multiparametric MRI workflow to guide software-fusion transrectal ultrasound (TRUS) biopsy for improved prostate cancer risk stratification. Feasibility was investigated in 3 prostate cancer patient studies, for which research biopsy targets corresponding to high pyruvate-to-lactate conversion rates (kPL) were identified and outlined by experienced abdominal radiologists. Fusion biopsies identified histologically-confirmed cancer at two out of three “C13” targets, consistent with clinically low- to intermediate-risk disease, supporting continued active surveillance management for these patients.
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