GlucoCEST MRI in Oncology

The roles of imaging in cancer may be divided into that of diagnosis and tumour detection, staging and assessment of response to treatment. Standard radiological techniques include ultrasound, Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET). A combination of imaging techniques is often necessary to differentiate between cancerous and normal tissue. Traditional imaging techniques identify cancers by their gross appearance and structural/ cellular characteristics, whilst PET do so by tracking glucose metabolism. PET owes its specificity to the high rate of glucose metabolism seen in most cancers. However it is not used routinely due to a lack of availability and high costs. In addition, PET is often used in combination with CT, which imparts a significant diagnostic radiation dose. This can increase an individual's risk of cancer, especially with childhood or early adult exposure. In contrast, MRI is more readily available and does not involve radiation. However its ability to detect cancer by tracking glucose metabolism has not been widely explored. Our group has recently developed a novel MRI technique called Gluco-CEST that can image glucose delivery, uptake and metabolism in cancer, therefore potentially allowing a radiation-free, one-stop imaging service that can be adapted to current generation of MRI scanners. This study aims to optimise the GlucoCEST technique, after which it will be rigorously tested and compared to standard imaging parameters and clinical or pathological reference standards to evaluate its diagnostic and predictive power across a number of cancer populations.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Healthy Volunteers:

  1. No previous history of cancer
  2. No known renal impairment or an eGFR within a standard reference value if there is a history of renal disease.
  3. Aged 18 or over with capacity to consent.
* Patient groups:

  1. Confirmed diagnosis of selected cancer types (head and neck, lymphoma and glioma)
  2. No known renal impairment or an eGFR within a standard reference value if there is a history of renal disease
  3. Aged 18 or over with capacity to consent.

Exclusion Criteria:

* For both groups:

  1. Confirmed diagnosis of selected cancer types (head and neck, lymphoma and glioma)
  2. Pregnancy
  3. Contradiction to MRI magnetic field (pacemaker, metallic implant, severe claustrophobia, etc)
  4. Allergy to MR contrast agent (Gadolinium)
  5. Adult with Impaired capacity
  6. Deranged renal function with eGFR

• BACKGROUNDWalker-Samuel S, Ramasawmy R, Torrealdea F, Rega M, Rajkumar V, Johnson SP, Richardson S, Goncalves M, Parkes HG, Arstad E, Thomas DL, Pedley RB, Lythgoe MF, Golay X. In vivo imaging of glucose uptake and metabolism in tumors. Nat Med. 2013 Aug;19(8):1067-72. doi: 10.1038/nm.3252. Epub 2013 Jul 7. PMID 23832090