New Imaging Agent Could Improve Prostate Cancer Diagnosis and Treatment

Pictured: PET Scan

This PET scan shows the pelvic region of a mouse with a prostate tumor (arrow). The red areas represent regions of high transferrin uptake.

A Memorial Sloan Kettering research team is developing a medical imaging agent that could result in better ways to detect prostate cancer and monitor a man’s risk of developing a life-threatening form of the disease.

Working in mice, the investigators used PET scans to track transferrin, a protein that normally is present in the bloodstream and can bind to fast-growing cells such as tumor cells. Their findings suggest that this strategy could be used to measure a biological process that is known to be highly active in some tumors, causing the onset of an aggressive form of prostate cancer. The researchers also found that transferrin PET scans might allow the disease to be detected early, before any tumor growth can be seen by conventional imaging techniques.

“If we can develop it for use in patients, this technology could have a broad impact on prostate cancer diagnosis and treatment monitoring,” says Jason Lewis, Vice Chair for Research in the Department of Radiology. He led the study, which was published in Nature Medicine in October, together with physician-scientist Charles L. Sawyers, Chair of the Human Oncology and Pathogenesis Program.

A New Imaging Agent

PET scans are sensitive imaging tests that can give detailed information about how tumors or body organs function. These scans produce three-dimensional images by tracking the location of a molecule that has been linked to a radioactive substance called a radionuclide and introduced into the body in low amounts.

Dr. Lewis and his colleagues designed a new PET imaging agent by coupling transferrin — a protein that occurs in the body naturally and plays a role in transporting iron to different tissues—to a radionuclide called zirconium-89.

Transferrin is more abundantly taken up by cancer cells compared to most normal cells and tissues, and has been explored for decades as a potential tool for cancer imaging and therapy. “However, earlier strategies to visualize transferrin uptake often produced images that were very challenging to interpret, mainly because of the properties of the radionuclides previously used,” Dr. Lewis says.

With zirconium, a longer-lived radionuclide, the researchers were able to detect and measure transferrin uptake in mouse models of prostate cancer, producing tumor images of unparalleled quality.

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Visualizing a Tumor’s Biology

The study also revealed that transferrin PET scans might offer a new way to noninvasively study the biology of a tumor.

“Prior work has shown that a tumor’s uptake of transferrin can be driven by the activity of MYC, a very important oncogene that commonly is mutated in many types of cancer,” says Michael Evans, a lead author of the study and a postdoctoral research associate in Dr. Sawyers’s lab. (Oncogenes are genes that, when mutated, can promote cancer development.)

In approximately 30 percent of men with prostate cancer, tumors carry mutations in MYC that are known to correlate with poor outcomes. The researchers found that their imaging technique can be used to measure the activity of MYC in tumors, making it possible to distinguish some aggressive tumors from those that are more benign.

In addition, the investigators discovered the method was capable of detecting prostate cancer early, before any evidence of disease can be found using conventional diagnostic tools such as biopsy, MRI scans, or CT scans. “This is most likely due to the fact that we are visualizing an underlying cause rather than a symptom of the disease,” Dr. Evans explains.

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Toward the Clinic

Efforts are now under way to develop the imaging agent for use in patients. The investigators note that transferrin PET scans could make it easier to manage prostate cancer in the future — for example, by allowing physicians to predict outcomes and make better-informed treatment decisions for newly diagnosed patients.

In some patients, the disease spreads quickly from the prostate to other organs, but in many others it is slow growing and unlikely to cause serious problems during a man’s lifetime. Dr. Evans says there is an unmet need for better tools to identify which patients need active treatment, so that men with less aggressive forms of prostate cancer can be spared from having therapies or invasive tests they don’t need.

The investigators also hope that transferrin PET could be used to track treatment responses to some new cancer drugs — in particular a new class of therapies that works by inhibiting MYC activity and is currently in patient trials — as well as to predict early which patients are most likely to benefit from such drugs.

“But prostate cancer is not the only disease in which transferrin PET scans might be useful,” Dr. Lewis adds. The investigators are exploring the potential use of the imaging agent in animal models of a number of other cancers, including breast cancer, lymphoma, and glioblastoma brain tumors.

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This research was supported in part by the National Institutes of Health under award numbers CA096945, CA83084, CA08748, and CA92629.


Commenting is disabled for this blog post.

Are transferrin PET scans now in use to detect mutations in MYC in tumors and are they available at Sloan Kettering?

Are transferrin PET scans to determine mutations in MYC in tumors now available at Sloan Kettering?

Dr. Lewis says that these scans are not available yet at Memorial Sloan-Kettering. Our researchers are working toward making them available through a clinical trial in the coming year. Thanks for your comment!

Does Sloan use image fusion guided biopsy techniques to increase the possibility of identifying cancerous tissue before a biopsy is performed?

Thank you for your comment. We are consulting with our physicians in Interventional Radiology and will post a response soon.

M Alex, we consulted with our imaging physicians and this is their reply to your question about image fusion guided biopsy techniques:

We use fusion imaging in biopsies where the safety profile or efficacy are improved by added image fusion. Fusion is typically used when the lesion is not visible on CT or ultrasound, but the lesion is visible on PET or MRI. The two most commonly fusion technologies are PET/CT fusion guided biopsy and MRI/ultrasound fusion guided biopsy.

What are the currently available alternatives to a needle biopsy of the prostate? I am not at all convinced I should undergo this and am actively looking for alternatives.

Lee, we are not able to provide individual medical advice on our blog. If you would like to learn more about how prostate cancer is diagnosed, we recommend you call the National Cancer Institute’s Cancer Information Service at 800-4CANCER. If you’d like to speak to an MSKCC doctor, you can call 800-525-2225 or go to for more information. Thank you for your comment.

Do you offer a biopsy of the prostate the fuses pre-biopsy MRI images of the prostate with ultrasound to locate evidence of cancers ?

Mr. Shine, yes, MSK does offer MRI-ultrasound fused guided biopsy of the prostate.

However, just to be clear, the story above discusses an experimental approach that uses transferrin as an imaging agent. This particular technology is in the preclinical phase (not currently available for patients) but our doctors hope this technology will be in the clinic by 2016.

How long will the lupron depot (6 month shot) stay in my system when the dose is done ..i have had it for 9 months total to date

Thanks for reaching out. Unfortunately, we are unable to answer specific medical questions on our blog. If you would like to make an appointment with a Memorial Sloan Kettering physician, please call our Physician Referral Service at 800-525-2225 or go to Thanks for your comment.

The transferrin PET scans & MYC activity sounds like promising research. I was at MSKCC in 1999 for a second opinion on prostate cancer. 3D conformal radiation was recommended. I had that at IU Health in Indianapolis along with Lupron. I had 7 good years until metastatic Prostate cancer was found in my bones. I have had many different treatments and hope that new ones will help slow down my cancer. Keep up the good work.
-=- Dave

Is this study being offered in a clinical trial yet?
thank you

Kathi, we checked with Dr. Lewis, who said this technology is still not available in trials, but trials are likely to begin sometime next year. Thank you for your comment.

I have had 3 PAC 3 Test. In October 2010 my level was 30 read as negative, July 2015 my level was 65 and in October 2015 the retest was 80 both considered positive.
The test were ordered due to spikes in PSA Score ,but now my PSA is at its lowest level in years. I have had 2 negative biophys the last in 2008 . Would any of the new test be of help in my case? Is a biopsy called for? Would MRI PET scans be useful to guide the biopsy.

William, thank you for reaching out. Unfortunately, we are unable to answer specific medical questions on our blog. We suggest you discuss these specific questions with your physician. If you would like to make an appointment with a Memorial Sloan Kettering physician, please call our Physician Referral Service at 800-525-2225 or go to Thanks for your comment.

I'am actively pursuing alternatives to needle biosphy for the prostate. Do offer any such procedures?

Dear J. Gregory, while blood and imaging tests can be helpful diagnostic tools, biopsy is the only way to confirm the diagnosis and aggressiveness of a prostate cancer. For more information about prostate biopsies, please visit….

If you would like to learn more about how prostate cancer is diagnosed, please visit

If you are interested in making an appointment with one of our specialists for a consultation, please call our Physician Referral Service at 800-225-2225. Thank you for reaching out to us.

I have had prostate Cancer for 19 years I tried Provenge 5 week treatment because my PSA was more than tripling They take the blood out send it for a cleaning to get the bad cells out your blood is given back 3 different times i waited 4 months to get a PET BONE SCAN the office mad a mistake and gave me a pet scan so we only found out that the lymph nodes in my stomach has increased and got larger the spot on my spine also increased they suggested a clinical trial INO-VT-464-CL001 It has 600mg of seviteronel and 05 mg Dexamethasone changed name of Zytiga and Predisone have you ever heard of this it was a different study they had to stop due to patients getting the shakes and memory loss and hullinations can you help

Does MSK use the latest 3T mpMRI BlueLaser™-to 3D image the Prostate and if necessary perform MRI Guided Biopsy

Dear Patrick, MSK routinely performs 3T mp prostate MRI, which is considered the current state-of-the-art standard care. Thank you for your comment.

For the diagnostic 3t mp prostate MRI, is an endorectal coil used in addition?

Dear David, currently MSK radiologists do not use an endorectal coil for prostate mp MRI studies done on 3T MRI machines. Thank you for your comment.

I am looking for a Biparametric MRI of my prostate because I do not wish to have the DCE contrast scan performed. Recent literature on indicate such a plan (BiParametric vs MultiParametric) is viable. Can this Biparametric (no contrast) MRI be performed at MSKCC? Thank you.

Dear Elliot, MSK performs prostate MRIs without using contrast agent for most patients. We follow very specific indications for contrast agent, which may be used only in some patients if it is deemed beneficial by our radiologists. Thank you for your comment, and best wishes to you.