Rivenzon-Segal, Dalia, Raanan Margalit, and Hadassa Degani. Glycolysis as a metabolic marker in orthotopic breast cancer, monitored by in vivo 13 C MRS. Am J Physiol Endocrinol Metab 283: E623-E630, 2002. First published May 21, 2002 10.1152/ajpendo.00050.2002.-Enhanced glycolysis represents a striking feature of cancers and can therefore serve to indicate a malignant transformation. We have developed a noninvasive, quantitative method to characterize tumor glycolysis by monitoring 13 C-labeled glucose and lactate with magnetic resonance spectroscopy. This method was applied in MCF7 human breast cancer implanted in the mammary gland of female CD1-NU mice and was further employed to assess tumor response to hormonal manipulation with the antiestrogen tamoxifen. Analysis of the kinetic data based on a unique physiological-metabolic model yielded the rate parameters of glycolysis, glucose perfusion, and lactate clearance in the tumor, as well as glucose pharmacokinetics in the plasma. Treatment with tamoxifen induced a twofold reduction in the rate of glycolysis and of lactate clearance but did not affect the other parameters. This metabolic monitoring can thus serve to evaluate the efficacy of new selective estrogen receptor modulators and may be further extended to improve diagnosis and prognosis of breast cancer. magnetic resonance spectroscopy; [ 13 C]glucose; [ 13 C]lactate GLUCOSE, AN ESSENTIAL COMPOUND for many living organisms, is an important carbon source for energy-producing metabolic processes and for the synthesis of low molecular weight and macromolecular products. For more than 70 years, it has been known that cancer cells utilize and metabolize glucose at high rates, even in the presence of high oxygen concentrations, to form mainly lactate (36). Indeed, lactate was found to be present in tumors at levels much higher than in the corresponding normal tissues (9,15,16,25). Furthermore, quantitative studies of biopsies from human cancers have indicated a positive correlation between tumor lactate concentration and incidence of metastasis (5,26,34,35). Increased glycolysis is associated with higher glucose uptake and metabolism, and it is now utilized as an indicator of malignancy by applying positron emission tomography (PET) with the glucose analog 2-[ 18 F]fluoro-2-deoxy-D-glucose (FDG) (2,23,29,33). FDG-PET has also been used for prognostic evaluation, for monitoring tumor therapy, and for early detection of recurrent cancer growth (2, 29, 33).
C magnetic resonance spectroscopy (MRS) with use of enriched [13 C]glucose can also serve to monitor in vivo glucose metabolism. Specifically, it monitors glucose uptake and consumption, and it traces other metabolites into which the 13 C label is incorporated, including lactate (28). Detailed kinetic MRS studies of 13 C-labeled glucose consumption and lactate synthesis were previously performed in cultured breast cancer cells (12,20,21,24). Similar in vivo MRS studies of tumors in animal models focused on evaluating lactate clearance (30) or lactate synthesi...