Characterization of serial hyperpolarized 13C metabolic imaging in patients with glioma

Pilot Study of Hyperpolarized 13C Metabolic Imaging in Pediatric Patients with Diffuse Intrinsic Pontine Glioma and Other CNS Cancers

“…[4][5][6][7][8] In addition to the record of safety, this study was able to provide evidence that HP-13 C imaging can capture metabolically relevant data. As reported in adults, [4][5][6][7][8] HP [1-13 C]pyruvate displayed transport across the BBB and subsequent conversion to [1-13 C]lactate and [ 13 C] bicarbonate over experimental time scales of approximately 60-72 seconds. Given the quality of these data, as measured by aSNR, HP- 13 C imaging appears to hold promise for investigating aberrant metabolism in pediatric brain tumors.…”

“…HP- 13 C MR imaging has enabled the noninvasive investigation of in vivo brain metabolism using molecular probes whose signal is transiently enhanced via dynamic nuclear polarization. 3 In studies of the adult brain, [4][5][6][7][8] intravenously injected HP [1-13 C]pyruvate was shown to safely transport across the BBB and undergo enzymatic conversion to downstream metabolites [1-13 C]lactate and [ 13 C]bicarbonate, which serve as respective markers of glycolysis 9 and oxidative phosphorylation. 10 Given the metabolic alterations associated with cancer, 11,12 several of these imaging studies were designed to demonstrate the feasibility of HP-13 C MR imaging in patients with gliomas 4,5 and also characterize serial imaging.…”

“…10 Given the metabolic alterations associated with cancer, 11,12 several of these imaging studies were designed to demonstrate the feasibility of HP-13 C MR imaging in patients with gliomas 4,5 and also characterize serial imaging. 8 Kinetic modeling of serial data has most importantly shown evidence of aberrant metabolism in patients with progressive glioblastoma. 8 Additionally, earlier studies in patients with prostate cancer have indicated potential clinical relevance, based on the elevated ratio of [1- 13 C] lactate to [1-13 C]pyruvate in biopsy-proved disease.…”

“…8 Kinetic modeling of serial data has most importantly shown evidence of aberrant metabolism in patients with progressive glioblastoma. 8 Additionally, earlier studies in patients with prostate cancer have indicated potential clinical relevance, based on the elevated ratio of [1- 13 C] lactate to [1-13 C]pyruvate in biopsy-proved disease. 13 Despite advances in the molecular characterization of pediatric brain tumors, development of imaging biomarkers has remained elusive.…”

Cardiac pH-Imaging With Hyperpolarized MRI

“…But the technique may have even more to offer in prognostication, patient selection and early treatment evaluation. For example, from the field of oncology, metabolic assessment with hyperpolarized MRI is reported to correlate with tumor grade ( 36 , 51 , 52 ) and depict the early metabolic response to chemotherapy ( 32 , 53 , 54 ). In cardiology, hyperpolarized MRI could be useful for selecting patients for novel metabolic or pH-altering therapy in heart failure ( 1 ), or for detecting the severity, reversibility and localization of ischemia in coronary artery disease.…”