We will develop and translate novel imaging biomarkers of tumour cell death to detect early treatment response in patients with cancer. Our approach will leverage the world-leading expertise and infrastructure at Cambridge (including the only hyperpolarised-probe pharmacy in Europe) to develop novel PET and MR imaging probes, including 18F-labelled C2Am, hyperpolarised [1,4-13C2] fumarate and advanced diffusion weighted magnetic resonance imaging (DW-MRI) methods.
Cell death is an important read out for imaging the early response of tumour to treatment and with our three approaches we will be able to image
• Apoptosis and necrosis (C2Am)
• Rapid onset of low level diffuse necrosis (hyperpolarised 13C fumarate)
• Large areas of confluent necrosis (DW-MRI)
Both hyperpolarised [1,4-13C2] fumarate and C2Am are first in man studies of novel imaging probes of early cell death.

If successful, our approach will allow very rapid clinical translation of these novel imaging agents, which were developed in Cambridge, from pre-clinical discoveries to proof-of-principle experimental medicine trials and ultimately routine clinical practice. Our long-term goal is the integration of quantitative non-invasive imaging measurements of cell death as an early marker of treatment response with genomic, ctDNA and other longitudinal measures of the cancer phenotype.