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The first-in-human hyperpolarized 1-13Cpyruvate+13C,15N2urea dual-agent MRI demonstrated the safety and feasibility of simultaneous characterization of prostate cancer metabolism and blood flow as a two-minute addition to the standard 1H-multiparametric MRI. Metabolism-perfusion mismatch (i.e. elevated pyruvate-lactate conversion and decreased urea perfusion) in subregions of the high-grade prostate tumor was in agreement with the histopathological and immunochemical markers that reflected lethal phenotypes and their associated hypoxic tumor microenvironment. Correlative analysis of urea and Gadolinium-derived pharmacokinetic parameters found low correlation between the two, which indicates that HP 13C urea’s unique contrast mechanism offers independent information inaccessible through conventional 1H DCE-MRI.
Chen et al. (Wed,) studied this question.