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Abstract #1944

Multimodal imaging of tumor metabolism and microenvironment in feline sarcoma patients using hyperpolarized 13C MRI and PET

Martin Grashei1, Tanja Groll2, Stephanie Kahl3, Silke Baer4, Elisabeth Bliemsrieder1, Frits H. A. van Heijster1, Andre Wendlinger1, Pascal Wodtke1, Jorge Cabello1, Susan Notohamiprodjo1, Christian Lohrmann1, Markus Schwaiger1, Wolfgang Weber1, Katja Steiger2, Andrea Meyer-Lindenberg5, Johannes Hirschberger3, Christine Baumgartner4, and Franz Schilling1
1Technical University of Munich, TUM School of Medicine and Health, Department of Nuclear Medicine, TUM University Hospital, Munich, Germany, 2Comparative Experimental Pathology (CEP), TUM School of Medicine and Health, Institute of Pathology, Technical University of Munich, Munich, Germany, 3Clinic of Small Animal Medicine, Ludwig-Maximilians-Universität München, Munich, Germany, 4Technical University of Munich, TUM School of Medicine and Health, Center for Preclinical Research, TUM University Hospital, Munich, Germany, 5Clinic of Small Animal Surgery and Reproduction, Centre of Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany

Synopsis

Keywords: Hyperpolarized MR (Non-Gas), Multi-Contrast, pH imaging, Sarcoma, Cat, PET/MR, Hyperpolarization, Pyruvate, Metabolism, Hypoxia

Motivation: Sarcomas are a rare but diverse cancer type with heterogeneous metabolic signatures. Their stratification is difficult, which limits treatment selection, therapy development and reliable patient prognosis.

Goal(s): To demonstrate the feasibility of combined hyperpolarized 13C MRI and PET to differentiate sarcoma subtypes and to identify prognostic imaging biomarkers.

Approach: Sarcoma cat patients were recruited, underwent PET/MR imaging and were followed-up several years post-surgery.

Results: Hyperpolarized 13C MRI of pH and pyruvate metabolism allow subtype and tumor grade differentiation while [18F]FMISO-PET and DWI do not. Image-derived tumor acidification appears to be predictive for patient outcome. Correlations between parameters reveal hypoxia-driven metabolism and related acidification.

Impact: Hyperpolarized 13C MRI allows sarcoma subtype and grade differentiation in cat patients in contrast to [18F]FMISO-PET and DWI. Acidification outperforms all other parameters as biomarker for cat patient prognosis, rendering hyperpolarized pH imaging a promising technique for clinical translation.

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Abstract

Keywords