Cancer Metabolism and Tumor Heterogeneity: Imaging Perspectives Using MR Imaging and Spectroscopy



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Cancer cells reprogram their metabolism to maintain viability via genetic mutations and epigenetic alterations, expressing overall dynamic heterogeneity. The complex relaxation mechanisms of nuclear spins provide unique and convertible tissue contrasts, making magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) pertinent imaging tools in both clinics and research. In this review, we summarized MR methods that visualize tumor characteristics and its metabolic phenotypes on an anatomical, microvascular, microstructural, microenvironmental, and metabolomics scale. The review will progress from the utilities of basic spin-relaxation contrasts in cancer imaging to more advanced imaging methods that measure tumor-distinctive parameters such as perfusion, water diffusion, magnetic susceptibility, oxygenation, acidosis, redox state, and cell death. Analytical methods to assess tumor heterogeneity are also reviewed in brief. Although the clinical utility of tumor heterogeneity from imaging is debatable, the quantification of tumor heterogeneity using functional and metabolic MR images with development of robust analytical methods and improved MR methods may offer more critical roles of tumor heterogeneity data in clinics. MRI/MRS can also provide insightful information on pharmacometabolomics, biomarker discovery, disease diagnosis and prognosis, and treatment response. With these future directions in mind, we anticipate the widespread utilization of these MR-based techniques in studying in vivo cancer biology to better address significant clinical needs.



Elasticity Imaging Techniques, Contrast-enhanced magnetic resonance imaging, Cells, Lung Neoplasms, Electron Spin Resonance Spectroscopy, Prostate-, Cancer, Brain--Tumors, Breast--Cancer, Cervix uteri--Cancer, Radiology, nuclear medicine & medical imaging, Lungs--Cancer, Neoplasms, Brain Neoplasms, Breast Neoplasms, Uterine Cervical Neoplasms

This work was supported by Chang Gung Medical Foundation grant CIRPG3E0022; National Science Council (Taiwan) MOST 104-2314-B-182A-095-MY3; National Institute of Health (USA) grant P30 CA008748, R01 CA195476, R21 CA212958, P41 EB015908, and S10 OD018468.


CC BY 4.0 (Attribution), ©2017 The Authors