First-in-human in vivo non-invasive assessment of intra-tumoral metabolic heterogeneity in renal cell carcinoma.

Intratumoral genetic heterogeneity and the role of metabolic reprogramming in renal cell carcinoma (RCC) have been extensively documented. However, the distribution of these metabolic changes within the tissue has not been explored. We report on the first-in-human non-invasive metabolic interrogation of RCC using hyperpolarized carbon-13 (C) magnetic resonance imaging (HP-MRI) and describe the validation of lactate metabolic heterogeneity against multi-regional mass spectrometry. HP-MRI provides an assessment of metabolism and provides a novel opportunity to safely and non-invasively assess cancer heterogeneity.