This review will highlight recent advances in hyperpolarized 13 C MR spectroscopic imaging, which can be used to noninvasively interrogate tumor metabolism. After providing an overview of MR and hyperpolarization, we will discuss the latest advances in data acquisition techniques. Next, we will shift our focus to hyperpolarized probe design and provide an overview of the latest hyperpolarized 13 C MR spectroscopic imaging probes developed in the last several years.Key Words: instrumentation; molecular imaging; MRI; dynamic nuclear polarization; metabolism; pulse sequences Nucl Med 2017; 58:1201 58: -1206 58: DOI: 10.2967 Int he setting of cancer, cellular metabolism is reprogrammed to support proliferation (1,2). Therefore, cancer cells exhibit a unique metabolic fingerprint that provides a means to differentiate them from benign tissues. Over the years, a variety of imaging probes have been developed to noninvasively detect cancer-specific metabolic changes. The most commonly used probe is the PET radiotracer 18 F-FDG, which structurally mimics glucose and exhibits increased uptake in malignant cells due to their elevated energetic demand. 18 F-FDG PET has been an effective tool for staging and restaging tumors to determine prognosis and therapeutic response, and it has demonstrated utility in detecting distant metastases (3). However, numerous enzymatic pathways downstream of cellular glucose uptake are also perturbed in cancer ( Fig. 1), and assessment of these alterations can provide additional criteria for tumor characterization and patient stratification. In recent years, the emergence of hyperpolarized 13 C MR spectroscopic imaging (MRSI) has provided a means to noninvasively quantify flux through enzymatic pathways in vivo. This technology is becoming increasingly clinically relevant as a new wave of drugs that target specific metabolic pathways-as opposed to DNA synthesis or repair mechanisms, which are the target of traditional chemotherapy-are entering the Food and Drug Administration-approval pipeline (4,5). In recent years, the field of hyperpolarized MRSI has made great strides toward improving data acquisition methods, while other groups in the field have developed an array of probes with the ability to noninvasively measure glycolysis, glutaminolysis, isocitrate dehydrogenase (IDH) activity, pH, and redox status.
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MAGNETIC RESONANCE AND HYPERPOLARIZATIONMRSI interrogates the magnetic properties of atomic nuclei to acquire an array of spatially resolved nuclear MR spectra throughout a volume of interest, such as a patient's body. The resonance frequency of a spectral peak, expressed in parts per million relative to the frequency of a reference standard, is known as its chemical shift and can be used to identify compounds and to quantify metabolite concentrations. With respect to cancer, this information can be used to determine malignancy and for tumor metabolic profiling (6). Furthermore, spectrometers can be tuned to selectively probe certain elements, for example, carbon, which is the focus ...