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Abstract #0572

Evaluating hyperpolarized [1-13C]pyruvate uptake for predicting response to stereotactic radiosurgery in brain metastases

Nicole I.C. Cappelletto1, Hany Soliman2, Casey Y. Lee1, Nadia D. Bragagnolo1,3, Arjun Sahgal2, Albert P. Chen4, Ruby Endre3, William J. Perks5, Nathan Ma5, Jay S. Detsky2, Chris Heyn6, and Charles H. Cunningham1,3
1Medical Biophysics, University of Toronto, Toronto, ON, Canada, 2Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 3Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada, 4GE Healthcare, Toronto, ON, Canada, 5Pharmacy, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 6Radiology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

Synopsis

Brain metastases are increasingly being treated with stereotactic radiosurgery; however, 20-30% of treated tumors recur locally post-treatment. Hyperpolarized [1-13C]pyruvate magnetic resonance imaging (HP 13C MRI) is an emerging metabolic imaging modality that measures key metabolic phenotypes indicative of tumor biology. Here we investigate pre-treatment [1-13C]pyruvate uptake – a potential marker of monocarboxylate transporter 1 expression and tumor vascularity – via HP 13C MR images as a predictor of local recurrence. [1-13C]pyruvate uptake establishes a robust predictive model (AUC = 0.73) and, as a result, can inform treatment decisions should the model predict a non-response to SRS.

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