Hyperpolarized C-13 MRI Techniques to Monitor Radiation Therapy Response in Prostate Cancer Patients

Project Summary/Abstract The goal of this research project is to investigate new 3D advanced hyperpolarized (HP) 13C-pyruvate MRI techniques to quantitatively monitor metabolic changes in prostate cancer following stereotactic body radiation therapy (SBRT) and to study HP 13C + multiparametric 1H MRI for detecting residual/progressive cancer following

RT, addressing current unmet clinical needs. This research trial is important because RT too often causes excess morbidity without sufficient efficacy and current imaging approaches are inadequate in identifying clinically significant cancer following RT. FDG-PET imaging is significantly limited in prostate cancer since in the localized

setting, significant excretion in the bladder precludes the ability to adequately detect signal within the prostate and even in the metastatic setting there is significant heterogeneity of uptake with substantial proportion of non- FDG avid, yet still metabolically active and growing tumors, for reasons related to intra-cellular uptake and

trapping of the FDG tracer. While we use PSMA-PET, to identify metastatic prostate cancer, it does not provide the metabolic information on prostate cancer aggressiveness and response to therapy that HP 13C has demonstrated in preclinical and initial human studies at our and other sites. Recent patient studies of this emerging imaging approach at multiple sites world-wide have shown repeatable

findings of greatly up-regulated LDH catalyzed pyruvate-to-lactate conversions in cancer using this safe, rapid, fast