Unveiling metabolic patterns within the human body: Advancements in ultra-high field MR imaging for early treatment assessment in cancer

Imaging can be a crucial tool in evaluating early therapy response in oncology. Limitations of traditional imaging techniques have led to the emergence of ultra-high field magnetic resonance (MR) metabolic imaging. With this advanced technique, metabolic changes can be detected, providing insight into therapy response even before morphological changes become visible.

This research introduces technical improvements, such as the use of local shim coils to create a uniform magnetic field, a two-dimensional spectral-spatial excitation pulse for spatial measurements of choline in the liver, and a phosphorus whole-body transmit coil for phosphorus metabolic imaging of the liver, which addresses the penetration range issue of surface coils. These innovative approaches offer opportunities for evaluating the response to tumor therapy in liver metastases. Additionally, two patients with hepatic metastases of gastro-esophageal cancer were included in this study, revealing promising biomarkers which may predict the (non-)response to chemotherapy already after 2 weeks. These findings demonstrate the potential of monitoring changes in tumor metabolism as a valuable tool for early assessment of therapy effectiveness. Because of the design of the phosphorus whole-body transmit coil, these measurements can now also be expanded to metabolic imaging of the pancreas. This is exemplified in our first demonstration of in vivo phosphorus metabolic imaging of healthy pancreatic tissue and in a patient with pancreatic cancer.

This research has contributed to understanding of tumor metabolism and its changes during treatment, and has opened up opportunities for applications in previously inaccessible areas of the human body.