Early diagnosis of brain metastases through biofluid metabolomics

Over 20% of cancer patients develop brain metastases. Current MRI diagnostic techniques only detect late stage metastases, since they rely on blood-brain-barrier permeability to allow contrast enhancement. Thus, new methods enabling earlier diagnosis are urgently needed. We have previously shown that it is possible to discriminate between different inflammatory lesions in the CNS in rats (1), as well as between different stages of multiple sclerosis in patients (2), through biofluid (blood/urine) metabolomics. We believe that this ability is due, at least in part, to alterations in CNS metabolism, which provoke a specific metabolic signature in the biofluids studied. It is known that tumour metabolism differs markedly from normal brain and that brain metabolism itself will be altered by tumour presence. On the basis of the above, therefore, we hypothesised that the presence of brain metastases could be detected, in vivo, through NMR analysis of biofluids