Noninvasive Assessment of Renal Tumor Aggressiveness using Hyperpolarized 13C MR

Kayvan R. Keshari¹, Bertram Koelsch, Rahwa Iman, Mark Van Criekinge, Daniel B. Vigneron, John Kurhanewicz, Zhen J. Wang

The widespread use of cross-sectional imaging has led to the incidental discovery of many renal tumors. However, triage of therapies is currently difficult due to our inability to reliably differentiate benign from malignant, or indolent from aggressive renal tumors noninvasively by conventional imaging techniques. In this study we use a combination steady-state [3-13C]pyruvate cell labeling and HP [1-13C]pyruvate cell culture bioreactor studies to show that HP13C MR has the potential to noninvasively characterize renal tumor aggressiveness. Specifically, increasing HP [1-13C]lactate may be a useful biomarker for discriminating benign from malignant, and indolent from aggressive renal tumors.