Hyperpolarised 13C-Pyruvate MRI Study

Metabolic changes related to disease are the precursor to anatomical changes in tissues. Currently the imaging methods routinely used in clinical practice look at the anatomical changes. Whilst these methods are very helpful in making clinical decisions, they are far from being perfect. Early disease can be missed because these methods are not sensitive enough and it is not clear whether disease is present or not. Additionally, it is also difficult to know whether disease it aggressive or non-aggressive. Hyperpolarised MRI is a new imaging tool that may allow addressing these deficiencies in current imaging technology. The process of hyperpolarisation allows the production of an injectable solution that can produce signal on a standard MRI scanner inferring information about the metabolism occurring at a particular location. This technology has only just become available for clinical use. The initial stages of evaluation require the investigators to refine and develop the new imaging protocols so that assessment can be made as to whether consistent results can be achieved. Additionally, refining the imaging protocol could also aid in identifying where the best potential future clinical use of this technology should be targeted. Within this application the investigators aim to try out hyperpolarised MRI in a number of different cancers and also see whether it is useful to assess cardiac metabolism. The investigators will be using 13C-labelled metabolites (for this study 13C- pyruvate) which will allow interrogation of glucose metabolism. The derangement of glucose metabolism is common to a number of disease processes.

Sex

All

Minimum age

18 Years

Maximum age

80 Years

Inclusion Criteria:

1. Age 18 years or over
2. Suspected Prostate Cancer/Renal Cancer/Rectal Cancer/Pancreatic Cancer
3. No current renal impairment or an eGFR within a standard reference value if there is a history of renal disease.
4. Subject able to comply with study procedures and provide informed consent.
5. Patient is willing to undergo MRI/Hyperpolarised 13C-Pyruvate MRI or with other nuclei and substrate (where appropriate).
6. Eastern Cooperative Oncology Group Performance Status (ECOG) of 0 or 2

Exclusion Criteria:

1. Contraindication to MRI (e.g cardiac pacemaker)
2. Contraindication to MR contrast agents
3. Pregnancy
4. Breast Feeding
5. Deranged renal function (eGFR\<30) -