A cutting edge technique that boosts the sensitivity of magnetic resonance imaging (MRI) more than 10,000 fold could allow cancer patients to find out within days of starting treatment how their tumours are likely to respond – a Cancer Research UK study published in Nature Medicine has revealed.
Establishing early on whether a drug is having the desired effect on a patient’s cancer – and if necessary changing to an alternative – can have considerable implications for survival. But patients’ response to treatment is largely assessed by monitoring the size of their tumours over time. And even if a drug is working, it can take weeks before the tumour stops growing or begins to shrink.
Now scientists in Cambridge using a super-sensitive scanning technique – developed by GE Healthcare – have captured images of a treatment given to mice with lymphoma taking effect shortly after being administered. The significantly enhanced MRI scans allowed the researchers to observe tumour cells being killed off, confirming that the drug was working. It is hoped further research will prove the technique is also effective in cancer patients.
Lead researcher, Cancer Research UK’s Professor Kevin Brindle, who is based at the Cambridge Research Institute, University of Cambridge, said: “It’s early days but if this technique proved effective in cancer patients, it would provide a vital early indication of response to treatment. This is important because the sooner a doctor identifies that a drug isn’t working as well as hoped, the sooner an alternative can be prescribed.”
MRI scans work by turning the radio wave signals sent out by atoms in the body into computer pictures. To get a sharper, more in-depth look at what was going on inside the mouse tumours, the research team used the new technique to ‘turn up’ the radio wave signals being sent out by a chemical cancer cells use to make energy. This made the chemical – which is called pyruvate – much more detectable by the MRI scan and allowed the scientists to follow its uptake and use by the tumour cells. A decrease in uptake pinpointed cells that were being killed off.
The pyruvate molecules were made more detectable, by cooling a sample of the chemical to absolute zero (-273?C). This changed the state of the atoms in the chemical’s molecules and made them emit a stronger radio wave signal. In order to give the pyruvate to the mice, the researchers had to bring the chemical back up to room temperature very rapidly. They did this by dissolving the pyruvate in superheated water. Once the mice had been given the pyruvate, they were quickly scanned before the atoms in the chemical’s molecules could go back to their normal state.
Professor Brindle added: “The technique we’ve developed is straightforward and fast acting. The pyruvate circulates around the body of the mice within just a few seconds, so images can be taken virtually straight away”.
It is hoped that clinical trials testing the imaging technique in cancer patients will take place in the future.
Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “This has the potential to be a very exciting development. Now that there are a wide range of cancer drugs available, being able to find out quickly whether a patient would be better off on another treatment could help many more people beat cancer.”
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Detecting tumor response to treatment using hyperpolarized 13C magnetic resonance imaging and spectroscopy. Day, S. E., Kettunen, M. I., Gallagher, F. A., Hu, D.-E., Lerche, M., Wolber, J., Golman, K., Ardenkjaer-Larsen, J. H., and Brindle, K. M. (2007) Nature Medicine 13, 1382 – 1387.
MRI images available on request.
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