Tel Aviv [Israel], Pancreatic cancer is known for its late detection and high mortality rate, but a new Israeli magnetic resonance imaging (MRI) approach that illuminates pancreatic tumors offers hope for earlier diagnoses and treatments .
The challenge of detecting pancreatic cancer arises from the pancreas' deep location in the abdominal cavity, which varies among individuals, and often obscures tumors until it is too late for effective treatment.
Although it is only the 12th most common form of cancer globally, pancreatic cancer was the sixth deadliest in 2020. Without better detection, pancreatic cancer is projected to become the deadliest form of cancer by 2030.
However, an innovative MRI method developed by the Weizmann Institute of Science tracks how cells metabolize glucose, similar to how glucose tolerance tests indicate diabetes. The findings were recently published in the peer-reviewed journal Science Advances.
Nearly a century ago, Nobel laureate Otto Warburg discovered that cancer cells consume glucose at unusually high rates compared to non-cancerous cells, a phenomenon now known as the Warburg effect.
This effect causes glucose to ferment into lactate instead of being completely metabolized into carbon dioxide. Taking advantage of this metabolic quirk, Weizmann's MRI method maps specific metabolic products unique to cancer cells, potentially enabling the identification of pancreatic cancer.
The researchers, led by Prof. Lucio Frydman and Prof. Avigdor Scherz, used chemically altered glucose containing a stable isotope of hydrogen called deuterium. This modified glucose was injected into mice with pancreatic tumors before scanning.
According to Frydman, this new method can overcome traditional MRIs and positron emission tomography (PET) scans, which have difficulty accurately identifying pancreatic tumors.
"Traditional MRI does not detect pancreatic tumors because, even when external contrast agents are added, the scan is not specific enough to highlight the presence and location of the cancer. Doctors cannot see the tumor until the patient feels its effects," Frydman said. saying.
"Even when the scan indicates an abnormality, it often cannot be distinguished from inflammation or a benign cyst. Likewise, PET scans cannot necessarily be trusted because a positive scan does not always mean the patient has cancer, and A negative PET scan does not always mean that the patient is cancer-free," he explained.
Standard preventive care for pancreatic cancer currently involves regular CT and MRI scans, often accompanied by invasive and uncomfortable endoscopic biopsies, but this combined approach rarely works. Researchers attempted to address this diagnostic gap by using MRI to detect the distinct metabolic patterns of normal and cancerous tissues.
"In healthy cells, glucose digestion ends with carbon dioxide, which we exhale," Frydman explained. "However, cancer cells stop this process early and produce lactate, which helps their proliferation."
The challenge was to detect the small amounts of lactate produced by cancer cells. Conventional MRI measures abundant protons in tissue water, overshadowing the weak lactate signal. To solve this, the researchers replaced the protons in glucose with deuterium. This “deuterated” glucose, when metabolized by cancer cells, produced detectable deuterated lactate, overcoming signal interference from water.
To improve the sensitivity of this method, Frydman's team developed advanced experimental and image processing techniques, significantly improving the detection of deuterated lactate. The new MRI images illuminated even the smallest tumors, while healthy tissues remained dark.
"Even if the cancer is not detected in time, deuterium MRI will help measure the rates at which the conversion of glucose to lactate occurs. This could provide a crucial metric for predicting the usefulness of certain treatments, or even determining whether a treatment is working. "This could establish deuterium MRI as the preferred method for diagnosing difficult-to-identify pancreatic tumors and choosing the treatment that will yield the best prognosis," Frydman said.
The challenge of detecting pancreatic cancer arises from the pancreas' deep location in the abdominal cavity, which varies among individuals, and often obscures tumors until it is too late for effective treatment.
Although it is only the 12th most common form of cancer globally, pancreatic cancer was the sixth deadliest in 2020. Without better detection, pancreatic cancer is projected to become the deadliest form of cancer by 2030.
However, an innovative MRI method developed by the Weizmann Institute of Science tracks how cells metabolize glucose, similar to how glucose tolerance tests indicate diabetes. The findings were recently published in the peer-reviewed journal Science Advances.
Nearly a century ago, Nobel laureate Otto Warburg discovered that cancer cells consume glucose at unusually high rates compared to non-cancerous cells, a phenomenon now known as the Warburg effect.
This effect causes glucose to ferment into lactate instead of being completely metabolized into carbon dioxide. Taking advantage of this metabolic quirk, Weizmann's MRI method maps specific metabolic products unique to cancer cells, potentially enabling the identification of pancreatic cancer.
The researchers, led by Prof. Lucio Frydman and Prof. Avigdor Scherz, used chemically altered glucose containing a stable isotope of hydrogen called deuterium. This modified glucose was injected into mice with pancreatic tumors before scanning.
According to Frydman, this new method can overcome traditional MRIs and positron emission tomography (PET) scans, which have difficulty accurately identifying pancreatic tumors.
"Traditional MRI does not detect pancreatic tumors because, even when external contrast agents are added, the scan is not specific enough to highlight the presence and location of the cancer. Doctors cannot see the tumor until the patient feels its effects," Frydman said. saying.
"Even when the scan indicates an abnormality, it often cannot be distinguished from inflammation or a benign cyst. Likewise, PET scans cannot necessarily be trusted because a positive scan does not always mean the patient has cancer, and A negative PET scan does not always mean that the patient is cancer-free," he explained.
Standard preventive care for pancreatic cancer currently involves regular CT and MRI scans, often accompanied by invasive and uncomfortable endoscopic biopsies, but this combined approach rarely works. Researchers attempted to address this diagnostic gap by using MRI to detect the distinct metabolic patterns of normal and cancerous tissues.
"In healthy cells, glucose digestion ends with carbon dioxide, which we exhale," Frydman explained. "However, cancer cells stop this process early and produce lactate, which helps their proliferation."
The challenge was to detect the small amounts of lactate produced by cancer cells. Conventional MRI measures abundant protons in tissue water, overshadowing the weak lactate signal. To solve this, the researchers replaced the protons in glucose with deuterium. This “deuterated” glucose, when metabolized by cancer cells, produced detectable deuterated lactate, overcoming signal interference from water.
To improve the sensitivity of this method, Frydman's team developed advanced experimental and image processing techniques, significantly improving the detection of deuterated lactate. The new MRI images illuminated even the smallest tumors, while healthy tissues remained dark.
"Even if the cancer is not detected in time, deuterium MRI will help measure the rates at which the conversion of glucose to lactate occurs. This could provide a crucial metric for predicting the usefulness of certain treatments, or even determining whether a treatment is working. "This could establish deuterium MRI as the preferred method for diagnosing difficult-to-identify pancreatic tumors and choosing the treatment that will yield the best prognosis," Frydman said.
