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Cribriform prostate cancer (crPCa) is associated with poor clinical outcomes, yet its accurate detection remains challenging due to the poor sensitivity of standard-of-care diagnostic tools. Here, we use untargeted spatial metabolomics to identify fatty acid biosynthesis as a key metabolic pathway enriched in crPCa epithelium. We also show that imaging tumor lipid metabolism using [1-11C]acetate PET/CT and proton magnetic resonance spectroscopy differentiates cribriform from noncribriform intermediate-risk prostate cancers in two prospective patient cohorts. These findings support the feasibility of using clinical metabolic imaging techniques as adjunctive tools for improving crPCa detection in clinical practice, with prospective studies in larger cohorts warranted to obtain definitive results.

Original publication

DOI

10.1073/pnas.2502423122

Type

Journal article

Journal

Proc Natl Acad Sci U S A

Publication Date

07/2025

Volume

122

Keywords

MRI, cancer metabolism, nuclear medicine, prostate cancer, spectroscopy, Male, Prostatic Neoplasms, Humans, Metabolomics, Positron Emission Tomography Computed Tomography, Lipid Metabolism, Prospective Studies, Aged, Fatty Acids, Middle Aged