Feasibility Of An Induced Metabolic Bioluminescence Imaging Technique In Ovarian Cancer: Results Of A Pilot Study.

e17093 Background: The precise determination of energy metabolites is challenged by the heterogeneity of their distribution, their rapid changes after surgical resection and the architectural complexity of malignancies. Induced metabolic bioluminescence imaging (imBI) allows to determine energy metabolites in tissue sections and to localize these as consecutive sections were stained with H&E. Here, we report whether the determination of ATP and lactate is feasible in suspicious peritoneal lesions in ovarian cancer (OC) using imBI. Methods: Patients with suspected advanced OC were enrolled in this prospective, pilot study. During surgery, samples of peritoneal metastases were resected and transferred in liquid nitrogen within 30 seconds. ATP and lactate concentrations were measured using imBI. Furthermore, the expression of monocarboxylate transporter (MCT)-1 and MCT-4 was determined by immunofluorescence staining. The correlations between lactate and MCT-1 as well as lactate and MCT-4 were calculated by the Spearman rank correlation coefficient. Results: 16 patients were screened, 12 finally entered the study. In all 12 cases high concentrations of ATP suggested that energy metabolism was not altered by the surgical and transport procedures (mean ± SD, 0.69 μmol/g ± 0.33). Final histological assessment revealed a benign peritoneal lesion in one case, which subsequently served as a benign reference. The concentration of lactate was remarkably higher in the 11 OC cases (mean ± SD, 23.03 μmol/g ± 8.86) compared to the benign reference (6.54 μmol/g ± 1.84). Lactate concentrations strongly correlated with MCT-1 (rho = 0.734, p = 0.007), but not with MCT-4 (rho = 0.315, p = 0.319). Conclusions: These results show that surgical and transport procedures and imBI are feasible in OC and encourage further effort to elucidate the role of lactate, MCT-1 and MCT-4 in OC.