Sensitivity and Specificity of Detecting Premalignant Pancreatic Lesions by Hyperpolarized Magnetic Resonance

Motivation: There is an unmet need for early diagnosis of pancreatic cancer due to the asymptomatic nature of the disease. Goal(s): The goal is to detect the early stages of pancreatic cancer by monitoring the altered metabolism in premalignant pancreatic lesions in vivo with hyperpolarized metabolic imaging. Approach: This is validated in two mechanistic pathways of cancer progression, (1) pancreatic intraepithelial neoplasia (PanIN), and (2) intraductal papillary mucinous neoplasm (IPMN). Results: Increased lactate flux is observed with progression of the premalignant lesions in both the pathways. No increase in lactate flux is observed in pancreatitis, a known confounder demonstrating the specificity of this technique. Impact: This research described has the potential for leading to practice-changing recommendations for non-invasively detecting and monitoring premalignant lesions and incipient pancreatic cancer, to prevent over-diagnosis and over-treatment of cysts that harbor indolent biology.