PET trick: Prostate cancer imaging sneakily looks to glucose, not lipids

While the prostate naturally relies on lipid metabolism, there is a way to reroute metabolic function and activate glucose uptake, which provides a novel means of FDG and other metabolic prostate imaging, according to a study presented during the American Association for Cancer Research (AACR) annual meeting being held April 5-9 in San Diego, Calif.

This new method means men with slow-growing prostate cancer could potentially undergo non-invasive metabolic prostate PET imaging instead of requiring multiple invasive procedures to monitor disease. Other PET agents are available but many are still under investigation or not as widely available as FDG. The announcement comes from the University of Colorado Denver, where the research was conducted.  

“Because prostate cancer can be a slow-growing disease, instead of immediate treatment, many men choose active surveillance – they watch and wait,” said Isabel Schlaepfer, PhD, a researcher in the department of pharmacology at UC’s Cancer Center, in a press release. “But that requires repeated prostate biopsies. Instead, now we could use this metabolic technique to allow PET imaging to monitor prostate cancer progression without the need for so many biopsies."

Schlaepfer is also a recipient of a Minority Scholar Award in Cancer Research from AACR this year.

The method calls on a drug called etomoxir, an inhibitor of fatty acid oxidation, which acts to blockade lipid metabolism, at the cellular level. Once lipid metabolism is blocked, prostate cells are forced to use alternative means for energy, namely glucose.

This diagnostic imaging technique could veer into the area of theranostics, because the researchers at UC believe that the same mechanism that reroutes lipid metabolism to glucose uptake could limit tumors’ ability to acquire energy and function properly, diminishing their viability.