Preliminary results from Improved Prediction in Ovarian Cancer Surgery [IMPROCAS]: a Hyperpolarized 13C Clinical Trial

Motivation: The most important determinant of survival for ovarian cancer patients is complete surgical resection, but current preoperative imaging methods cannot predict this accurately. Hyperpolarized 13C MRI enables imaging of cancer metabolism, potentially improving diagnostics of adnexal masses. Goal(s): To explore the utility of Hyperpolarized 13C MRI to detect metabolic changes in adnexal masses comparred with 18F-FDG-PET/CT. Approach: Presenting the first two cases from the IMPROCAS trial, where 18FDG-PET/CT and 1H/13C MRI were performed. Results: In patient 1, an 18F-FDG-avid ovarian mass did not produce increased 13C-lactate and was histopathologically benign. In patient 2, the primary ovarian tumour had 18F-FDG-uptake and increased lactate production. Impact: This is the first presentation of a direct FDG/Hyperpolarized 13C pyruvate comparison of histopathologically benign and malign ovarian masses and highlights the metabolic distinction of the techniques and their synergistic utility. This is of broad interest in oncology.