In real time
Scientists have developed a new method of monitoring breast cancer
Scientists have developed a new scanning method using magnetized molecules, which allows real-time observation of which areas of the breast tumor are active and to what extent. The description is published in the journal Proceedings of the National Academy of Sciences (Gallagher et al., Imaging breast cancer using hyperpolarized carbon-13 MRI – VM).
British scientists from the Cancer Research Center in Cambridge and the Department of Radiology at the University of Cambridge have demonstrated for the first time in practice that a scanning technique called hyperpolarized carbon-13 mapping can be used to monitor breast cancer.
Carbon pyruvate is a salt of pyruvic acid, is the end product of the breakdown of glucose and other sugars. In the course of the study, scientists hyperpolarized, or in other words, magnetized carbon pyruvate-13 – a molecule of natural pyruvate labeled with a heavy carbon isotope. To do this, they cooled it to a temperature just one degree above absolute zero, to -272 degrees Celsius, and exposed it to extremely strong magnetic fields and microwave radiation.
The scientists dissolved the material thawed after treatment in an injection solution, which was then injected into patients before an MRI scan. Magnetized carbon-13 pyruvate molecules increased the signal strength by 10,000 times, and all the details of the tumor were clearly visible on the scan.
The technique was tested on seven patients with different types and degrees of breast cancer. Thanks to the new method, scientists were able not only to more accurately determine the size, type and degree of tumor development, but also, by observing in real time how the tumor metabolizes pyruvate, to determine how quickly and aggressively cancer develops.
The new scanning method also displays the "topography" of the tumor in more detail than traditional MRI, showing differences in metabolism between its regions.
"This is one of the most detailed pictures of breast cancer metabolism that we have ever been able to get. We literally see how the tumor "breathes", – the words of the head of the study Kevin Brindle are quoted in the press release of the Cancer Research Center. "Combined with modern advances in genetic testing, this scanning method will in the future allow doctors to better adapt treatment for each person and monitor how patients respond to treatment, for example, chemotherapy."
The researchers used a new method to measure the rate of transition of pyruvate to lactate. This transformation is part of the metabolic processes that produce energy and building blocks for the creation of new cells.
Tumors have a different metabolism compared to healthy cells and produce lactate faster. This rate also varies between tumors and between different areas of the same tumor. The authors have shown that monitoring this transformation in real time can be used to determine the type and aggressiveness of breast cancer.
The usual image of a breast tumor (left) and the images taken by the new method showing the signal of pyruvate (center) and lactate (right). Photo: Cancer Research UK.
"This exciting scanning process can provide new information about the metabolic status of each patient's tumor after diagnosis, which will help doctors determine the best course of treatment," says Charles Swanton, another author of the study. "And a simple, non–invasive scan can be repeated periodically during treatment, giving an idea of whether there is a result, whether it is necessary to switch to more intensive treatment or, conversely, to reduce the dose."
At the next stage of the study, scientists plan to test the new scanning method on large groups of patients to find out whether it can be reliably used to justify treatment decisions in hospitals.
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