Keywords: Prostate, Multimodal, Metabolic Imaging, Prostate Cancer, Hyperpolarized MR
Motivation: Many advanced prostate cancer (PCa) patients receiving anti-androgens (Enzalutamide) as the first line of treatment, develop resistance which relapses into metastatic castrate-resistant PCa (mCRPC) with an alarming low survival rate of only 28%.
Goal(s): The overarching goal of this research is thus to develop personalized metabolic imaging modality to target treatment strategies of different metabolic sub-types of PCa.
Approach: By targeting pyruvate-to-lactate metabolism by hyperpolarized [1-13C]-pyruvate MR and fatty acid oxidation by 18F-FPIA PET.
Results: HP-MR is effective in classifying resistant and sensitive PCa and interrogating an MCT1 inhibitor, Syrosingopine, that is effective in sensitizing a resistant phenotype.
Impact: The research described has the potential to lead practice-changing recommendations by detecting therapeutic efficacy earlier and changing the patient to a different therapeutic regiment. This research also has the potential to recommend combination therapy in the clinic to resistant patients.
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