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Deen SS, Rooney C, Shinozaki A, McGing J, Grist JT, Tyler DJ, Serrão E, Gallagher FA. Hyperpolarized Carbon 13 MRI: Clinical Applications and Future Directions in Oncology. Radiol Imaging Cancer 2023; 5:e230005. [PMID: 37682052 PMCID: PMC10546364 DOI: 10.1148/rycan.230005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/16/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023]
Abstract
Hyperpolarized carbon 13 MRI (13C MRI) is a novel imaging approach that can noninvasively probe tissue metabolism in both normal and pathologic tissues. The process of hyperpolarization increases the signal acquired by several orders of magnitude, allowing injected 13C-labeled molecules and their downstream metabolites to be imaged in vivo, thus providing real-time information on kinetics. To date, the most important reaction studied with hyperpolarized 13C MRI is exchange of the hyperpolarized 13C signal from injected [1-13C]pyruvate with the resident tissue lactate pool. Recent preclinical and human studies have shown the role of several biologic factors such as the lactate dehydrogenase enzyme, pyruvate transporter expression, and tissue hypoxia in generating the MRI signal from this reaction. Potential clinical applications of hyperpolarized 13C MRI in oncology include using metabolism to stratify tumors by grade, selecting therapeutic pathways based on tumor metabolic profiles, and detecting early treatment response through the imaging of shifts in metabolism that precede tumor structural changes. This review summarizes the foundations of hyperpolarized 13C MRI, presents key findings from human cancer studies, and explores the future clinical directions of the technique in oncology. Keywords: Hyperpolarized Carbon 13 MRI, Molecular Imaging, Cancer, Tissue Metabolism © RSNA, 2023.
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Affiliation(s)
- Surrin S Deen
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Catriona Rooney
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Ayaka Shinozaki
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Jordan McGing
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - James T Grist
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Damian J Tyler
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Eva Serrão
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
| | - Ferdia A Gallagher
- From the Department of Radiology, Cambridge University Hospitals, Biomedical Campus, Cambridge, CB2 0QQ, England (S.S.D., E.S., F.A.G.); Department of Physiology, Anatomy, and Genetics (C.R., A.S., J.T.G., D.J.T.) and the Oxford Centre for Clinical Magnetic Resonance Research (A.S., J.T.G., D.J.T.), University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England (J.M., J.T.G.); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England (J.T.G.); Department of Radiology, University of Cambridge, Cambridge, England (E.S., F.A.G.); Cancer Research UK Cambridge Centre, Cambridge, England (F.A.G.); and Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (E.S.)
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von Morze C, Blazey T, Baeza R, Garipov R, Whitehead T, Reed GD, Garbow JR, Shoghi KI. Multi-band echo-planar spectroscopic imaging of hyperpolarized 13 C probes in a compact preclinical PET/MR scanner. Magn Reson Med 2022; 87:2120-2129. [PMID: 34971459 DOI: 10.1002/mrm.29145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/02/2021] [Accepted: 12/15/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE Hyperpolarized (HP) 13 C MRI has enabled real-time imaging of specific enzyme-catalyzed metabolic reactions, but advanced pulse sequences are necessary to capture the dynamic, localized metabolic information. Herein we describe the design, implementation, and testing of a rapid and efficient HP 13 C pulse sequence strategy on a cryogen-free simultaneous positron emission tomography/MR molecular imaging platform with compact footprint. METHODS We developed an echo planar spectroscopic imaging pulse sequence incorporating multi-band spectral-spatial radiofrequency (SSRF) pulses for spatially coregistered excitation of 13 C metabolites with differential individual flip angles. Excitation profiles were measured in phantoms, and the SSRF-echo planar spectroscopic imaging sequence was tested in rats in vivo and compared to conventional echo planar spectroscopic imaging. The new sequence was applied for 2D dynamic metabolic imaging of HP [1-13 C]pyruvate and its molecular analog [1-13 C] α -ketobutyrate at a spatial resolution of 5 mm × 5 mm × 20 mm and temporal resolution of 4 s. We also obtained simultaneous 18 F-fluorodeoxyglucose positron emission tomography data for comparison with HP [1-13 C]pyruvate data acquired during the same scan session. RESULTS Measured SSRF excitation profiles corresponded well to Bloch simulations. Multi-band SSRF excitation facilitated efficient sampling of the multi-spectral kinetics of [1-13 C]pyruvate and [1-13 C] α - ketobutyrate . Whereas high pyruvate to lactate conversion was observed in liver, corresponding reduction of α -ketobutyrate to [1-13 C] α -hydroxybutyrate ( α HB) was largely restricted to the kidneys and heart, consistent with the known expression pattern of lactate dehydrogenase B. CONCLUSION Advanced 13 C SSRF imaging approaches are feasible on our compact positron emission tomography/MR platform, maximizing the potential of HP 13 C technology and facilitating direct comparison with positron emission tomography.
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Affiliation(s)
- Cornelius von Morze
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA
| | - Tyler Blazey
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA
| | | | | | - Timothy Whitehead
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA
| | | | - Joel R Garbow
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA
| | - Kooresh I Shoghi
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA
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