Human Hepatocellular Carcinoma Metabolism: Imaging by Hyperpolarized13C Magnetic Resonance Spectroscopy.
OBJECTIVE
Most cancers exhibit high levels of aerobic glycolytic metabolism with diminished levels of mitochondrial oxidative phosphorylation even in the presence of normal or near-normal levels of oxygen ("Warburg effect"). However, technical challenges have limited the development of non-invasivein vivoimaging techniques for monitoring glycolytic metabolism of hepatocellular carcinoma (HCC) and quantitatively evaluating the impact of this effect on the growth and therapy of this disease. Thus, there is a critical need to develop non-invasive techniques for longitudinal assessment of the metabolism and treatment response of patients with unresectable HCCs.


METHODS
This article discusses a novel method, "Hyperpolarized13C MRS imaging", for achieving this objective and thus improving the prognosis of HCC patients. The primary objective has been to characterizein vivometabolic biomarkers as determinants of HCC metabolism and treatment response of unresectable HCC tumors or viable HCC cells.


RESULTS
This innovative technique capitalizes on a new technology that increases the sensitivity of MRS detection of crucial metabolites in cancer cells.


CONCLUSIONS
It is anticipated that this innovative approach will lead to improved methods, both for the diagnosis and staging of HCCs and for the facilitation of the development of enzyme targeted therapies and other therapeutic interventions.
Departments of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
Moses M
MM
Darpolor
David E
DE
Kaplan
Peter L
PL
Pedersen
Jerry D
JD
Glickson
Alanine Transaminase; Branched-Chain Aminotransferases; Hepatocellular Carcinoma; Hyperpolarized 13C MRS; [1-13C] pyruvate; “Warburg effect”