Detecting pancreatic cancer early is challenging because the pancreas is located deep in the abdomen, and its position varies among individuals.
This often allows tumors to remain hidden until it’s too late for effective treatment.
However, researchers at the Weizmann Institute of Science have developed a new magnetic resonance imaging (MRI) method that could make pancreatic tumors “light up” in scans, potentially leading to earlier detection and better outcomes.
Their findings are published in the journal Science Advances.
This new MRI method tracks how cells metabolize glucose, similar to how glucose tolerance tests indicate diabetes.
Nearly a century ago, Nobel Prize-winning scientist Otto Warburg discovered that tumors consume large amounts of glucose compared to normal cells, and most of this glucose ferments into lactate—a phenomenon known as the Warburg effect.
By mapping the specific metabolic products that arise only in cancer cells, the Weizmann MRI method could help identify pancreatic cancer early.
The research was conducted using rodent models of aggressive pancreatic cancer in Professor Lucio Frydman’s lab at Weizmann’s Chemical and Biological Physics Department, in collaboration with Professor Avigdor Scherz of the Plant and Environmental Sciences Department.
To develop this novel MRI method, the scientists used a chemically altered glucose containing a stable isotope of hydrogen called deuterium. They injected this altered glucose into the bloodstream of mice with pancreatic cancers before scanning.
Traditional MRI and positron emission tomography (PET) scans have struggled to detect pancreatic tumors accurately. Traditional MRI often fails to highlight the presence and location of cancer, while PET scans can give false positives or negatives. Preventive care usually involves CT and MRI scans, often with invasive biopsies, but this approach is not very effective.
Frydman and his team aimed to find new signatures of pancreatic cancer by using MRI to map how normal and cancerous tissues metabolize glucose. Healthy cells fully digest glucose into carbon dioxide (CO2), which we exhale. However, cancer cells stop glucose digestion at an intermediate point, producing lactate. This process gives cancer cells a survival advantage by helping them multiply and invade surrounding tissues.
The challenge was that the amount of lactate produced in cancer cells was too low for conventional MRI to detect. MRI measures the abundant protons in water in the scanned tissues, and the water signal is about 100,000 times stronger than the lactate signal. To overcome this, Frydman’s team used two clever techniques.
First, they replaced glucose’s protons with deuteriums, a nonradioactive form of hydrogen. When cancer cells “ate” this deuterized glucose, it produced deuterized lactate, which produced a stronger MRI signal than water-borne protons. Although the signals were still faint, the team developed experimental and image-processing methods that increased sensitivity by more than ten times. This “deuterium MRI” could then detect even tiny amounts of deuterized lactate.
The results were clear: even low concentrations of deuterized lactate made millimeter-sized tumors light up in scans, while the rest of the scan remained dark. This method was much more sensitive than other MRI techniques that only monitor the final step of glucose digestion in cancer cells.
While this research was conducted on animal models, Frydman believes that deuterium MRI offers new hope for early detection of pancreatic cancer in humans. Future clinical studies could show that deuterium MRI is a lifesaving tool for individuals at risk of this disease. Although it doesn’t offer a cure, it could help measure the glucose-to-lactate conversion rate, predict treatment effectiveness, and choose the best treatment options.
“Deuterium MRI could become the preferred method for diagnosing hard-to-identify pancreatic tumors and determining the most effective treatments,” says Frydman. This innovative technique could significantly improve the early detection and management of pancreatic cancer, offering new hope to patients.
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