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Abstract #4657

Evaluating the metabolic effects of neoadjuvant treatment in clear cell renal cell carcinoma using hyperpolarised [1-13C]pyruvate-MRI

Ines Horvat-Menih1, Mary A McLean1, Jonathan Birchall1, Maria Jesus Zamora Morales1, Marta Wylot1, Ashley Grimmer1, Elizabeth Latimer1, Alixander S Khan1, Andrew Priest1, Andrew Gill1, Joshua Kaggie1, Martin J Graves1, Tristan Barrett1, Anne Warren2, Brent O'Carrigan3, James O Jones4, Sarah Welsh5, Thomas J Mitchell6, Antony Riddick3, James Armitage3, Grant D Stewart6, and Ferdia A Gallagher7
1Radiology, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom, 2Pathology, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom, 3Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom, 4Oncology, University of Cambridge, Cambridge, United Kingdom, 5Pinto Medical Consultancy, Cambridge, United Kingdom, 6Surgery, University of Cambridge, Cambridge, United Kingdom, 7Radiology, University of Cambridge, Cambridge, United Kingdom

Synopsis

Keywords: Hyperpolarized MR (Non-Gas), Hyperpolarized MR (Non-Gas)

Motivation: Late-stage renal cell carcinoma (RCC) has poor prognosis, requiring earlier intervention. However, current imaging biomarkers are late indicators of treatment response.

Goal(s): To evaluate hyperpolarised carbon-13 MRI (HP 13C-MRI) in assessing response to neoadjuvant treatment in RCC.

Approach: Four patients with operable RCC underwent HP 13C-MRI and proton (1H) MRI before and after treatment, to evaluate changes in tumour size, LAC/PYR ratio and imaging surrogates for perfusion, hypoxia, and diffusion.

Results: Changes in tumour size were minimal, and 1H-MRI biomarkers showed consistent changes across patients. Changes in LAC/PYR ratio varied across patients and was independent of changes in tumour size and 1H-MRI parameters.

Impact: HP 13C-MRI may be an independent early biomarker for RCC treatment response. Detection of differential metabolic changes before morphological and function changes on MRI may help to tailor treatments earlier, potentially saving lives and reducing costs.

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Keywords