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Abstract #0927

Hyperpolarized 13C Pyruvate MR-Assisted Longitudinal Risk Stratification in Prostate Cancer Patient – From Surveillance to Surgery

Hsin-Yu Chen1, Hao G. Nguyen2, Zhen J. Wang1, Michael A. Ohliger1, Jeffry P. Simko2, Matthew R. Cooperberg2, Daniel Gebrezgiabhier1, Lucas Carvajal1, Jeremy W. Gordon1, John Kurhanewicz1, Rahul Aggarwal2, Daniel B. Vigneron1, and Robert A. Bok1
1Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, 2Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States


Serial hyperpolarized 13C+mpMRI and paired metabolic image-guided biopsy were employed in a new integrative active surveillance (AS) paradigm, exemplified by a patient who initially enrolled in AS for 5 years, but later underwent radical prostatectomy upon progression. Metabolic biomarker kPL images detected early progression preceding radiologic and clinical parameters. Final whole-gland histopathology also linked kPL and PI-RADS targets to multifocal tumors, where kPL spatially reflected intratumoral heterogeneity, and high kPL regions correlated with adverse pathologic features such as G4 cribriform pattern, extracapsular extension, and lymphovascular invasion. Results indicated HP 13C may help optimize AS by improving clinical risk calculation.

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