An MD/PhD Collaboration to Apply Hyperpolarized 13 C Metabolic MRI for Assessing Renal Tumor Aggressiveness in Patients
Z.Jane Wang, MD and Peder Larson, PhD, faculty members in the UC San Francisco Department of Radiology and Biomedical Imaging are collaborating on a project applying hyperpolarized (HP) carbon 13 (13C) metabolic MRI in patients with renal tumors. The overall goal of their study is to improve risk stratification of localized renal tumors to guide their management and to avoid overtreatment (i.e., avoid unnecessary surgery). They recently achieved two important milestones.
The first milestone is a paper published in Cancer, an international interdisciplinary journal of the American Cancer Society. Renal tumors are frequently discovered incidentally because of the increased use of medical imaging, but it is challenging to risk stratify these tumors to identify which ones require definitive treatment such as surgery versus ones that can safely undergo active surveillance to avoid risks of surgery and potential loss of renal function. In this study, the team of investigators from UCSF Radiology, Urology, Pathology and the Helen Diller Family Comprehensive Cancer Center applied HP 13 C Metabolic MRI to noninvasively predict renal tumor aggressiveness. Their preliminary imaging results were compared with tumor samples taken during surgery and showed a trend toward differentiating between low‐grade and high‐grade clear cell renal cell carcinomas, which are the most common type of renal cancers.
“The paper represents the first study of a cohort of renal tumor patients with HP 13 C MRI technology with correlation to tumor pathology,” says Dr. Larson, co-author with Dr. Wang. “The results demonstrate the feasibility of HP 13C pyruvate MRI for investigating the metabolic phenotype of localized renal tumors, and exciting initial trends separating low-grade and high-grade tumors.”
Jeremy Gordon, PhD and Daniel Vigneron, PhD, faculty from UCSF Radiology, contributed to this work along with James Slater, RPh, PhD, senior research pharmacist and Shuyu Tang, PhD, former graduate student in the UC Berkeley - UCSF Graduate Group in Bioengineering, and a graduate of the UCSF Masters of Biomedical Imaging (MSBI) program. Additional authors from UCSF include Maxwell Meng, MD (Urology) and Bradley Stohr, MD (Pathology).
The second milestone is an R01 grant award from National Cancer Institute (NCI) to continue developing and applying this technology over the next 5 years. The grant, titled “Translating Hyperpolarized 13C Metabolic MRI to Predict Renal Tumor Aggressiveness,” aims to clinically translate hyperpolarized (HP) 13C pyruvate MRI as an innovative metabolic imaging approach for noninvasive prediction of renal tumor aggressiveness, an unmet clinical need.
Support from the Hyperpolarized MRI Technology Resource Center (HMTRC) at UCSF, a Biomedical Resource Technology Center funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) (P41EB013598), and the American Cancer Society through a Research Scholar Grant to Dr. Larson (131715‐RSG‐18‐005‐01‐CCE) has been crucial for this groundbreaking work. Additional funding for this work was made possible through funding from National Institutes of Health - Grant Numbers: U01EB026412.