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.
Horvat‐Menih et al. (Tue,) studied this question.
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