Magnetic Resonance Imaging of Glucose Uptake and Metabolism in Patients with Head and Neck Cancer.

Jihong Wang,Stephen Y Lai,Abdallah S R Mohamed,Yao Ding,Ken-Pin Hwang,Clifton D Fuller,Joseph Weygand,Jinyuan Zhou,Steven J Frank

doi:10.1038/srep30618

Abstract

Imaging metabolic dysfunction, a hallmark of solid tumors, usually requires radioactive tracers. Chemical exchange saturation transfer (CEST) imaging can potentially detect and visualize glucose uptake and metabolism, without the need for radioisotopes. Here, we tested the feasibility of using glucose CEST (glucoCEST) to image unlabeled glucose uptake in head and neck cancer by using a clinical 3T magnetic resonance imaging (MRI) scanner. The average CEST contrast between tumors and normal tissue in 17 patients was 7.58% (P = 0.006) in the 3–4 ppm offset frequency range and 5.06% (P = 0.02) in 1–5 ppm range. In a subgroup of eight patients, glucoCEST signal enhancement was higher in tumors than in normal muscle (4.98% vs. 1.28%, P < 0.021). We conclude that glucoCEST images of head and neck cancer can be obtained with a clinical 3T MRI scanner.

Highlights

Growing cancer cells typically have much higher rates of glycolysis than do their normal tissues of origin[1,2,3,4]
Our study showed that the Chemical exchange saturation transfer (CEST) signal in head and neck cancer can be reliably detected and was comparable to that reported for brain tumors[19,20,21]
Our results demonstrate the feasibility and potential utility of glucoCEST for assessing glucose uptake and tumor metabolism in head and neck cancer on a clinical 3T magnetic resonance imaging (MRI) scanner

Summary

Introduction

Growing cancer cells typically have much higher rates of glycolysis than do their normal tissues of origin[1,2,3,4]. High rates of glucose uptake in tumors appear as increased activity on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) images, and this is the underlying principle of PET imaging for cancer staging and treatment assessment[5]. CEST has been shown to detect glucose concentrations of a few millimoles in vivo. Unlike PET/computed tomography (CT), CEST imaging does not involve ionizing radiation, carries little to no risk to the patient, and can be repeated as necessary for cancer diagnosis, staging, and assessment of response. To the best of our knowledge, this is the first CEST imaging study in which a standard clinical (3T) MRI scanner was used to detect unlabeled glucose uptake in a prospective cohort of patients with human papillomavirus–positive (HPV+) oropharyngeal head and neck cancer

Methods

Results

Conclusion