Predictions of Human Prostate Cancer with MRS Metabolomics from Biopsies After More Than 5-Year Follow-Up

Motivation: Evaluations of prostate cancer (PCa) with traditional transrectal ultrasound (TRUS) and multiparametric MRI-ultrasound (mpMRI-US) fusion biopsies may produce false-positives or false-negatives, thereby preventing optimal and timely treatments. Goal(s): To evaluate PCa metabolomics from TRUS and fusion biopsy cores using magnetic resonance spectroscopy (MRS) to identify potential metabolomic biomarkers for better characterization of PCa. Approach: Using ex vivo MRS, we measured 432 prostate biopsy cores from patients suspicious of PCa between 4/2006 and 10/2018. Results: MRS metabolomics could differentiate between benign and malignancy, reflect malignant status from benign cores, and allowed for predictions of future PCa from benign biopsies. Impact: Our results demonstrate that MRS-based metabolomic evaluations have the potential to detect PCa years earlier than standard TRUS and fusion biopic techniques, and improve PCa active surveillance based on prostate biology.