Hyperpolarized nuclear magnetic resonance (HP-NMR) can probe the reaction kinetics of metabolic enzymes in vivo (1), and the translation of this technology into human patients based on the most commonly used tracer 13 C-pyruvate has been initiated in recent years (2). Currently the metabolite signal ratios are used as indicators for biological processes in healthy and diseased status. For example, to probe the reaction of lactate dehydrogenase (LDH) with hyperpolarized 13 C-pyruvate, the peak, mean, or integrated (area-undercurve) signal ratios of 13 C-lactate to 13 C-pyruvate are used to differentiate tumor and normal tissues, and to evaluate treatment response (3-5). However, these ratios do not have clearly defined biochemical meaning, and it is desirable to quantify the reaction rate constants. The accurate determination of reaction rate constants remains a challenge. The first-order rate constants of LDH reaction have been quantified in tissues by modeling the signal time courses of hyperpolarized 13 C-labeled pyruvate and lactate (3-7). Nevertheless, the rate constant quantification suffers from inaccuracy for the following reasons: Both intracellular and extracellular 13 C-labeled pyruvate contributes to the detected HP-NMR signal, but it is the intracellular pyruvate that is coupled to the LDH reaction in the cell. The extracellular space (ECS) volume fraction varies with tissue and physiological state, being about 20% in brain and up to 70% in tumor (8,9). A significant increase in the lactate/pyruvate ratio when using hyperpolarized [1-13 C]alanine compared to hyperpolarized [1-13 C]pyruvate have been reported in rats (10). This results support the significant contribution to HP-NMR signals by extracellular pyruvate that does not involve in LDH reaction directly. The modeling of hyperpolarized pyruvate signals without differentiating signals from intracellular and ECS will underestimate the reaction rate constant for the conversion of pyruvate to lactate. This underestimation is expected to be particularly severe for some perfused organ studies using non-selective radiofrequency pulses for signal acquisition (5); The transport of tracer from blood to interstitial space, and then through cell membrane to intracellular space complicates the mathematical modeling of enzyme kinetics. The rate constants determined for LDH by the two-site exchange modeling are really apparent rate constants, depending on the speeds of these transport processes (11). To determine the kinetic constants of an intracellular enzyme in vivo more accurately by HP-NMR, here I propose a simple pre-tracer approach to remove the complexities caused by extracellular metabolite signals and transport processes. Generally speaking, a hyperpolarized isotopelabeled pre-tracer (A), once it enters the space of interest (e.g., inside the cell), will be converted to the tracer of interest (B) via a local chemical reaction (e.g., by an intracellular enzyme E 1 ) ( Figure 1A). The tracer B will then be converted into additional metabolites of ...