Pancreatic ductal
adenocarcinoma (PDAC) is a deadly
cancer that progresses without any symptom, and oftentimes, it is detected at an advanced stage. The lack of prior symptoms and effective treatments have created a knowledge gap in the management of this lethal disease. This issue can be addressed by developing novel noninvasive imaging-based
biomarkers in PDAC. We explored in vivo hyperpolarized (HP) 13C MRS of
pyruvate to
lactate conversion and ex vivo 1H NMR spectroscopy in a panel of well-annotated patient-derived PDAC xenograft (PDXs) model and investigated the correlation between aberrant glycolytic metabolism and aggressiveness of the
tumor. Real-time metabolic imaging data demonstrate the immediate intracellular conversion of HP 13C
pyruvate to
lactate after
intravenous injection interrogating upregulated
lactate dehydrogenase (LDH) activity in aggressive PDXs. Total ex vivo
lactate measurement by 1H NMR spectroscopy showed a direct correlation with in vivo dynamic
pyruvate-to-
lactate conversion and demonstrated the potential of dynamic metabolic flux as a
biomarker of total
lactate concentration and aggressiveness of the
tumor. Furthermore, the metabolite concentrations were very distinct among all four
tumor types analyzed in this study. Overexpression of
LDH-A and
hypoxia-inducible factor (HIF-1α) plays a significant role in the conversion kinetics of HP
pyruvate-to-
lactate in
tumors. Collectively, these data identified aberrant metabolic characteristics of
pancreatic cancer PDXs and could potentially delineate metabolic targets for therapeutic intervention. Metabolic imaging with HP
pyruvate and NMR metabolomics may enable identification and classification of aggressive subtypes of patient-derived xenografts. Translation of this real-time metabolic technique to the clinic may have the potential to improve the management of patients at high risk of developing
pancreatic diseases.