An MRI-based imaging method can predict how ovarian cancer tumors will react to treatments, offering prompt insights into the effectiveness of the therapies used in cell models derived from patients.
A novel MRI imaging method created at the University of Cambridge estimates how ovarian cancer tumors will respond to therapy, providing quick feedback on treatment efficacy using patient-derived cell models.
This method, known as hyperpolarised carbon-13 imaging, enhances the MRI signal by over 10,000 times. Researchers discovered that it can differentiate between two types of ovarian cancer, showcasing their treatment responses.
Utilizing patient-derived cell models that effectively replicate the behavior of human high-grade serous ovarian cancer, which is the most common and deadly variant of the disease, the technique clearly indicates whether a tumor is responsive or resistant to Carboplatin, a standard chemotherapy for ovarian cancer.
This advancement allows oncologists to estimate how well a patient may respond to their treatment and assess the effectiveness of the therapy within the first 48 hours.
As various types of ovarian cancer respond differently to medications, current testing methods can leave patients waiting weeks or even months to discover if their cancer is responding. The immediate feedback from this innovative technique will enable oncologists to tailor treatments for each patient within a matter of days.
The study compared this hyperpolarised imaging technique with Positron Emission Tomography (PET) scans, which are commonly used in clinics. The findings revealed that PET scans failed to identify metabolic disparities between tumor subtypes, making them unable to predict the specific type of tumor present.
The findings are published today in the journal Oncogene.
Professor Kevin Brindle from the University of Cambridge’s Department of Biochemistry and lead author of the report stated, “This technique provides insights into how aggressive an ovarian cancer tumor is, allowing doctors to evaluate multiple tumors in one patient for a comprehensive assessment of disease prognosis, leading to more appropriate treatment choices.”
Patients with ovarian cancer frequently have numerous tumors distributed throughout their abdomen. It is impractical to biopsy every tumor, especially since they may belong to different subtypes that respond variably to treatments. Since MRI is a non-invasive method, the hyperpolarised imaging technique allows oncologists to examine all tumors simultaneously.
“We can image a tumor before treatment to gauge the likelihood of its response, and then re-image it right after treatment to verify if it has indeed responded,” said Brindle. “This will empower doctors to determine the best treatment for each patient and adapt it when necessary.”
“One of the most common inquiries from cancer patients is whether their treatment is effective. Rapidly directing patients to the most effective treatment would undoubtedly be beneficial,” he added.
The next phase involves testing the method on ovarian cancer patients, with scientists expecting this to commence within the next few years.
Hyperpolarised carbon-13 imaging employs an injectable solution containing a ‘labeled’ version of a naturally occurring molecule known as pyruvate. This pyruvate infiltrates the body’s cells, and the imaging reveals how quickly it is broken down into lactate. The speed of this metabolic process indicates the tumor subtype, which in turn reflects its treatment responsiveness.
This research supports the potential of hyperpolarised carbon-13 imaging for broader clinical implementation. Brindle, who is also part of the Cancer Research UK Cambridge Institute, has been refining this imaging technique to explore various cancers over the past two decades, including breast, prostate, and glioblastoma—a prevalent and aggressive brain tumor. Glioblastoma exhibits distinct subtypes with varying metabolism rates, which can be visualized to forecast their treatment responses. The inaugural clinical study in Cambridge, published in 2020, focused on breast cancer patients.
Annually, around 7,500 women in the UK receive an ovarian cancer diagnosis, with about 5,000 of those diagnosed with the most aggressive variant known as high-grade serous ovarian cancer (HGSOC).
The survival rate for ovarian cancer remains alarmingly low, with only 43% of women in England surviving five years post-diagnosis. Symptoms can often go unnoticed, leading to the disease spreading before diagnosis, complicating both imaging and treatment efforts.
