Researchers at the Weizmann Institute of Science have development a new approach to Magnetic Resonance Imaging (MRI) testing that could reveal the presence of pancreatic tumors.
The researchers have demonstrated how an emerging magnetic resonance imaging approach could make pancreatic tumors “light up” in MRI scans: altered glucose digested by cancer cells helps reveal the tumors’ hiding places.
Pancreatic cancer is difficult to detect, in part because the pancreas sits deep in the abdominal cavity in a position that can vary from person to person.
As a result, pancreatic tumors therefore can remain hidden until it is too late for treatment.
Standard preventive care for pancreatic cancer involves periodic CT and MRI scans, often accompanied by invasive and uncomfortable endoscopic biopsies, but this combined approach rarely works.
Similar to glucose tolerance tests, which can indicate the onset of diabetes by measuring how the body digests sugar, the new MRI method tracks how cells “eat” – that is, metabolize – glucose.
Nearly a century ago, German Jewish scientist and Nobel Prize laureate Otto Warburg discovered that tumors consume unusually large amounts of glucose relative to most non-cancerous cells.
Warburg also noticed that most glucose consumed by tumors ferments to lactate, a phenomenon that became known as the Warburg effect.
By showing how MRI can be used to distinguish and map the specific metabolic products that, as a result of the Warburg effect, arise only in cancer cells, the new Weizmann MRI method might offer a way to “check in” and identify the presence of pancreatic cancer.
The method could lead to earlier detection, better treatment and a more hopeful outcome for pancreatic cancer patients, the scientists said.
The research was conducted using rodent models of aggressive pancreatic cancer, performed in Prof. Lucio Frydman’s lab in Weizmann’s Chemical and Biological Physics Department in collaboration with Prof. Avigdor Scherz of the Plant and Environmental Sciences Department.
To develop the novel MRI method, the scientists used a chemically altered glucose containing a stable isotope of hydrogen called deuterium. Prior to scanning, this altered glucose was injected into the bloodstream of mice with pancreatic cancers.
“Traditional MRI fails to detect pancreatic tumors because, even when external contrast agents are added, the scanning is not specific enough to highlight the presence and location of the cancer,” says Frydman.
“Doctors can’t see the tumor until the patient feels its effects. Even when the scan indicates an abnormality, it often cannot be distinguished from an 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 the patient is cancer free,” he explains.
“In healthy cells, the end product of glucose digestion is CO2, the gas we exhale when we breathe out. But Otto Warburg discovered that cancer cells do not eat glucose ‘all the way.’ Instead, glucose digestion stops at an intermediate point to produce lactate, a molecule that is believed to play an important role in cancer cell division and proliferation,” Frydman adds.
“We all love sugar – who can say ‘no’ to a good ice cream sundae!”
