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Parasoglou P, Osorio RS, Khegai O, Kovbasyuk Z, Miller M, Ho A, Dehkharghani S, Wisniewski T, Convit A, Mosconi L, Brown R. Phosphorus metabolism in the brain of cognitively normal midlife individuals at risk for Alzheimer's disease. NEUROIMAGE. REPORTS 2022; 2:100121. [PMID: 36532654 PMCID: PMC9757821 DOI: 10.1016/j.ynirp.2022.100121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background Neurometabolic abnormalities and amyloid-beta plaque deposition are important early pathophysiologic changes in Alzheimer's disease (AD). This study investigated the relationship between high-energy phosphorus-containing metabolites, glucose uptake, and amyloid plaque using phosphorus magnetic resonance spectroscopy (31P-MRS) and positron emission tomography (PET). Methods We measured 31P-MRS, fluorodeoxyglucose (FDG)-PET, and Pittsburgh Compound B (PiB)-PET in a cohort of 20 cognitively normal middle-aged adults at risk for AD. We assessed 31P-MRS reliability by scanning a separate cohort of 13 healthy volunteers twice each. We calculated the coefficient-of-variation (CV) of metabolite ratios phosphocreatine-to-adenosine triphosphate (PCr/α-ATP), inorganic phosphate (Pi)-to-α-ATP, and phosphomonoesters-to-phosphodiesters (PME/PDE), and pH in pre-defined brain regions. We performed linear regression analysis to determine the relationship between 31P measurements and tracer uptake, and Dunn's multiple comparison tests to investigate regional differences in phosphorus metabolism. Finally, we performed linear regression analysis on 31P-MRS measurements in both cohorts to investigate the relationship of phosphorus metabolism with age. Results Most regional 31P metabolite ratio and pH inter- and intra-day CVs were well below 10%. There was an inverse relationship between FDG-SUV levels and metabolite ratios PCr/α-ATP, Pi/α-ATP, and PME/PDE in several brain regions in the AD risk group. There were also several regional differences among 31P metabolites and pH in the AD risk group including elevated PCr/α-ATP, depressed PME/PDE, and elevated pH in the temporal cortices. Increased PCr/α-ATP throughout the brain was associated with aging. Conclusions Phosphorus spectroscopy in the brain can be performed with high repeatability. Phosphorus metabolism varies with region and age, and is related to glucose uptake in adults at risk for AD. Phosphorus spectroscopy may be a valuable approach to study early changes in brain energetics in high-risk populations.
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Affiliation(s)
- Prodromos Parasoglou
- Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Ricardo S. Osorio
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Oleksandr Khegai
- Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Zanetta Kovbasyuk
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Margo Miller
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Amanda Ho
- Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Seena Dehkharghani
- Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
- Department of Neurology, Center for Cognitive Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Thomas Wisniewski
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
- Department of Neurology, Center for Cognitive Neurology, New York University Grossman School of Medicine, New York, NY, USA
- Department of Pathology, New York University Grossman School of Medicine, New York, NY, USA
| | - Antonio Convit
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
- Nathan S Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York, NY, USA
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
| | - Ryan Brown
- Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
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2
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Topping GJ, Heid I, Trajkovic-Arsic M, Kritzner L, Grashei M, Hundshammer C, Aigner M, Skinner JG, Braren R, Schilling F. Hyperpolarized 13C Spectroscopy with Simple Slice-and-Frequency-Selective Excitation. Biomedicines 2021; 9:biomedicines9020121. [PMID: 33513763 PMCID: PMC7911979 DOI: 10.3390/biomedicines9020121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/16/2021] [Accepted: 01/23/2021] [Indexed: 01/01/2023] Open
Abstract
Hyperpolarized 13C nuclear magnetic resonance spectroscopy can characterize in vivo tissue metabolism, including preclinical models of cancer and inflammatory disease. Broad bandwidth radiofrequency excitation is often paired with free induction decay readout for spectral separation, but quantification of low-signal downstream metabolites using this method can be impeded by spectral peak overlap or when frequency separation of the detected peaks exceeds the excitation bandwidth. In this work, alternating frequency narrow bandwidth (250 Hz) slice-selective excitation was used for 13C spectroscopy at 7 T in a subcutaneous xenograft rat model of human pancreatic cancer (PSN1) to improve quantification while measuring the dynamics of injected hyperpolarized [1-13C]lactate and its metabolite [1-13C]pyruvate. This method does not require sophisticated pulse sequences or specialized radiofrequency and gradient pulses, but rather uses nominally spatially offset slices to produce alternating frequency excitation with simpler slice-selective radiofrequency pulses. Additionally, point-resolved spectroscopy was used to calibrate the 13C frequency from the thermal proton signal in the target region. This excitation scheme isolates the small [1-13C]pyruvate peak from the similar-magnitude tail of the much larger injected [1-13C]lactate peak, facilitates quantification of the [1-13C]pyruvate signal, simplifies data processing, and could be employed for other substrates and preclinical models.
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Affiliation(s)
- Geoffrey J. Topping
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (G.J.T.); (M.G.); (C.H.); (M.A.); (J.G.S.)
| | - Irina Heid
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (I.H.); (L.K.); (R.B.)
| | - Marija Trajkovic-Arsic
- Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK, Partner Site Essen), 45147 Essen, Germany;
- German Cancer Research Center, DKFZ, 69120 Heidelberg, Germany
- Institute of Developmental Cancer Therapeutics, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany
| | - Lukas Kritzner
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (I.H.); (L.K.); (R.B.)
| | - Martin Grashei
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (G.J.T.); (M.G.); (C.H.); (M.A.); (J.G.S.)
| | - Christian Hundshammer
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (G.J.T.); (M.G.); (C.H.); (M.A.); (J.G.S.)
| | - Maximilian Aigner
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (G.J.T.); (M.G.); (C.H.); (M.A.); (J.G.S.)
| | - Jason G. Skinner
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (G.J.T.); (M.G.); (C.H.); (M.A.); (J.G.S.)
| | - Rickmer Braren
- Institute of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (I.H.); (L.K.); (R.B.)
- German Cancer Consortium (DKTK, Partner Site Munich), 81675 Munich, Germany
| | - Franz Schilling
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (G.J.T.); (M.G.); (C.H.); (M.A.); (J.G.S.)
- Correspondence:
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3
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Feuerecker B, Michalik M, Hundshammer C, Schwaiger M, Bruchertseifer F, Morgenstern A, Seidl C. Assessment of 213Bi-anti-EGFR MAb treatment efficacy in malignant cancer cells with [1- 13C]pyruvate and [ 18F]FDG. Sci Rep 2019; 9:8294. [PMID: 31165773 PMCID: PMC6549183 DOI: 10.1038/s41598-019-44484-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 05/13/2019] [Indexed: 12/02/2022] Open
Abstract
Evaluation of response to therapy is among the key objectives of oncology. A new method to evaluate this response includes magnetic resonance spectroscopy (MRS) with hyperpolarized 13C-labelled metabolites, which holds promise to provide new insights in terms of both therapeutic efficacy and tumor cell metabolism. Human EJ28Luc urothelial carcinoma and LN18 glioma cells were treated with lethal activity concentrations of a 213Bi-anti-EGFR immunoconjugate. Treatment efficacy was controlled via analysis of DNA double-strand breaks (immunofluorescence γH2AX staining) and clonogenic survival of cells. To investigate changes in metabolism of treated cells vs controls we analyzed conversion of hyperpolarized [1-13C]pyruvate to [1-13C]lactate via MRS as well as viability of cells, lactate formation and lactate dehydrogenase activity in the cellular supernatants and [18F]FDG uptake in treated cells vs controls, respectively. Treatment of malignant cancer cells with 213Bi-anti-EGFR-MAb induced intense DNA double-strand breaks, resulting in cell death as monitored via clonogenic survival. Moreover, treatment of EJ28Luc bladder cancer cells resulted in decreased cell viability, [18F]FDG-uptake and an increased lactate export. In both EJ28Luc and LN18 carcinoma cells treatment with 213Bi-anti-EGFR-MAb triggered a significant increase in lactate/pyruvate ratios, as measured with hyperpolarized [1-13C]pyruvate. Treatment with 213Bi-anti-EGFR-MAb resulted in an effective induction of cell death in EJ28Luc and LN18 cells. Lactate/pyruvate ratios of hyperpolarized [1-13C]pyruvate proved to detect early treatment response effects, holding promise for future clinical applications in early therapy monitoring.
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Affiliation(s)
- Benedikt Feuerecker
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany. .,German Cancer Consortium (DKTK), partner site Munich and German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Michael Michalik
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany
| | - Christian Hundshammer
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany.,Department of Chemistry, Technical University of Munich, Garching, Germany.,Munich School of Bioengineering, Technical University of Munich, Garching, Germany
| | - Markus Schwaiger
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany
| | - Frank Bruchertseifer
- European Commission, Joint Research Centre, Directorate for Nuclear Safety and Security, Karlsruhe, Germany
| | - Alfred Morgenstern
- European Commission, Joint Research Centre, Directorate for Nuclear Safety and Security, Karlsruhe, Germany
| | - Christof Seidl
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany.,Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Obstetrics and Gynecology, Munich, Germany
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4
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Hundshammer C, Braeuer M, Müller CA, Hansen AE, Schillmaier M, Düwel S, Feuerecker B, Glaser SJ, Haase A, Weichert W, Steiger K, Cabello J, Schilling F, Hövener JB, Kjær A, Nekolla SG, Schwaiger M. Simultaneous characterization of tumor cellularity and the Warburg effect with PET, MRI and hyperpolarized 13C-MRSI. Am J Cancer Res 2018; 8:4765-4780. [PMID: 30279736 PMCID: PMC6160766 DOI: 10.7150/thno.25162] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/26/2018] [Indexed: 02/07/2023] Open
Abstract
Modern oncology aims at patient-specific therapy approaches, which triggered the development of biomedical imaging techniques to synergistically address tumor biology at the cellular and molecular level. PET/MR is a new hybrid modality that allows acquisition of high-resolution anatomic images and quantification of functional and metabolic information at the same time. Key steps of the Warburg effect-one of the hallmarks of tumors-can be measured non-invasively with this emerging technique. The aim of this study was to quantify and compare simultaneously imaged augmented glucose uptake and LDH activity in a subcutaneous breast cancer model in rats (MAT-B-III) and to study the effect of varying tumor cellularity on image-derived metabolic information. Methods: For this purpose, we established and validated a multimodal imaging workflow for a clinical PET/MR system including proton magnetic resonance (MR) imaging to acquire accurate morphologic information and diffusion-weighted imaging (DWI) to address tumor cellularity. Metabolic data were measured with dynamic [18F]FDG-PET and hyperpolarized (HP) 13C-pyruvate MR spectroscopic imaging (MRSI). We applied our workflow in a longitudinal study and analyzed the effect of growth dependent variations of cellular density on glycolytic parameters. Results: Tumors of similar cellularity with similar apparent diffusion coefficients (ADC) showed a significant positive correlation of FDG uptake and pyruvate-to-lactate exchange. Longitudinal DWI data indicated a decreasing tumor cellularity with tumor growth, while ADCs exhibited a significant inverse correlation with PET standard uptake values (SUV). Similar but not significant trends were observed with HP-13C-MRSI, but we found that partial volume effects and point spread function artifacts are major confounders for the quantification of 13C-data when the spatial resolution is limited and major blood vessels are close to the tumor. Nevertheless, analysis of longitudinal data with varying tumor cellularity further detected a positive correlation between quantitative PET and 13C-data. Conclusions: Our workflow allows the quantification of simultaneously acquired PET, MRSI and DWI data in rodents on a clinical PET/MR scanner. The correlations and findings suggest that a major portion of consumed glucose is metabolized by aerobic glycolysis in the investigated tumor model. Furthermore, we conclude that variations in cell density affect PET and 13C-data in a similar manner and correlations of longitudinal metabolic data appear to reflect both biochemical processes and tumor cellularity.
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Oehmigen M, Lindemann ME, Gratz M, Neji R, Hammers A, Sauer M, Lanz T, Quick HH. A dual-tuned 13 C/ 1 H head coil for PET/MR hybrid neuroimaging: Development, attenuation correction, and first evaluation. Med Phys 2018; 45:4877-4887. [PMID: 30182463 DOI: 10.1002/mp.13171] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/11/2018] [Accepted: 08/20/2018] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This study aims to develop, implement, and evaluate a dual-tuned 13 C/1 H head coil for integrated positron emission tomography/magnetic resonance (PET/MR) neuroimaging. The radiofrequency (RF) head coil is designed for optimized MR imaging performance and PET transparency and attenuation correction (AC) is applied for accurate PET quantification. MATERIAL AND METHODS A dual-tuned 13 C/1 H RF head coil featuring a 16-rung birdcage was designed to be used for integrated PET/MR hybrid imaging. While the open birdcage design can be considered inherently PET transparent, all further electronic RF components were placed as far as possible outside of the field-of-view (FOV) of the PET detectors. The RF coil features a rigid geometry and thin-walled casing. Attenuation correction of the RF head coil is performed by generating and applying a dedicated 3D CT-based template attenuation map (μmap). Attenuation correction was systematically evaluated in phantom experiments using a large-volume cylindrical emission phantom filled with 18-F-Fluordesoxyglucose (FDG) radiotracer. The PET/MR imaging performance and PET attenuation correction were then evaluated in a patient study including six patients. RESULTS The dual-tuned RF head coil causes a mean relative attenuation difference of 8.8% across the volume of the cylindrical phantom, while the local relative differences range between 1% and 25%. Applying attenuation correction, the relative difference between the two measurements with and without RF coil is reduced to mean value of 0.5%, with local differences of ±3.6%. The quantitative results of the phantom measurements were corroborated by patient PET/MR measurements. Patient scans using the RF head coil show a decrease of PET signal of 5.17% ± 0.81% when compared to the setup without RF head coil in place, which served as a reference scan. When applying attenuation correction of the RF coil in the patient measurements, the mean difference to a measurement without RF coil was reduced to -0.87% ± 0.65%. CONCLUSION A dual-tuned 13 C/1 H RF head coil was designed and evaluated regarding its potential use in integrated PET/MR hybrid imaging. Attenuation correction was successfully applied. In conclusion, the RF head coil was successfully integrated into PET/MR hybrid imaging and can now be used for 13 C/1 H multinuclear hybrid neuroimaging in future studies.
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Affiliation(s)
- Mark Oehmigen
- High-Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany
| | - Maike E Lindemann
- High-Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany
| | - Marcel Gratz
- High-Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany.,Erwin L. Hahn Institute for MR Imaging, University Duisburg-Essen, Essen, Germany
| | - Radhouene Neji
- MR Research Collaborations, Siemens Healthcare, Frimley, UK.,Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Alexander Hammers
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | | | | | - Harald H Quick
- High-Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany.,Erwin L. Hahn Institute for MR Imaging, University Duisburg-Essen, Essen, Germany
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Eldirdiri A, Posse S, Hanson LG, Hansen RB, Holst P, Schøier C, Kristensen AT, Johannesen HH, Kjaer A, Hansen AE, Ardenkjaer-Larsen JH. Development of a Symmetric Echo-Planar Spectroscopy Imaging Framework for Hyperpolarized 13C Imaging in a Clinical PET/MR Scanner. Tomography 2018; 4:110-122. [PMID: 30320211 PMCID: PMC6173787 DOI: 10.18383/j.tom.2018.00006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Here, we developed a symmetric echo-planar spectroscopic imaging (EPSI) sequence for hyperpolarized 13C imaging on a clinical hybrid positron emission tomography/magnetic resonance imaging system. The pulse sequence uses parallel reconstruction pipelines to separately reconstruct data from odd-and-even gradient echoes to reduce artifacts from gradient imbalances. The ramp-sampled data in the spatiotemporal frequency space are regridded to compensate for the chemical-shift displacements. Unaliasing of nonoverlapping peaks outside of the sampled spectral width was performed to double the effective spectral width. The sequence was compared with conventional phase-encoded chemical-shift imaging (CSI) in phantoms, and it was evaluated in a canine cancer patient with ameloblastoma after injection of hyperpolarized [1-13C]pyruvate. The relative signal-to-noise ratio of EPSI with respect to CSI was 0.88, which is consistent with the decrease in sampling efficiency due to ramp sampling. Data regridding in the spatiotemporal frequency space significantly reduced spatial blurring compared with direct fast Fourier transform. EPSI captured the spatial distributions of both metabolites and their temporal dynamics in vivo with an in-plane spatial resolution of 5 × 9 mm2 and a temporal resolution of 3 seconds. Significantly higher spatial and temporal resolution for delineating anatomical structures in vivo was achieved for EPSI metabolic maps than for CSI maps, which suffered spatiotemporal blurring. The EPSI sequence showed promising results in terms of short acquisition time and sufficient spectral bandwidth of 500 Hz, allowing to adjust the trade-off between signal-to-noise ratio and encoding speed.
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Affiliation(s)
- Abubakr Eldirdiri
- Department of Electrical Engineering, Center for Hyperpolarization in Magnetic Resonance, Technical University of Denmark, Denmark
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark
| | - Stefan Posse
- Departments of Neurology
- Physics and Astronomy
- Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM
| | - Lars G. Hanson
- Department of Electrical Engineering, Center for Hyperpolarization in Magnetic Resonance, Technical University of Denmark, Denmark
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark
| | - Rie B. Hansen
- Department of Electrical Engineering, Center for Hyperpolarization in Magnetic Resonance, Technical University of Denmark, Denmark
| | - Pernille Holst
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Christina Schøier
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Annemarie T Kristensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Helle Hjorth Johannesen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Adam E. Hansen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jan Henrik Ardenkjaer-Larsen
- Department of Electrical Engineering, Center for Hyperpolarization in Magnetic Resonance, Technical University of Denmark, Denmark
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Timm KN, Miller JJ, Henry JA, Tyler DJ. Cardiac applications of hyperpolarised magnetic resonance. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 106-107:66-87. [PMID: 31047602 DOI: 10.1016/j.pnmrs.2018.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/14/2018] [Accepted: 05/29/2018] [Indexed: 05/05/2023]
Abstract
Cardiovascular disease is the leading cause of death world-wide. It is increasingly recognised that cardiac pathologies show, or may even be caused by, changes in metabolism, leading to impaired cardiac energetics. The heart turns over 15 times its own weight in ATP every day and thus relies heavily on the availability of substrates and on efficient oxidation to generate this ATP. A number of old and emerging drugs that target different aspects of metabolism are showing promising results with regard to improved cardiac outcomes in patients. A non-invasive imaging technique that could assess the role of different aspects of metabolism in heart disease, as well as measure changes in cardiac energetics due to treatment, would be valuable in the routine clinical care of cardiac patients. Hyperpolarised magnetic resonance spectroscopy and imaging have revolutionised metabolic imaging, allowing real-time metabolic flux assessment in vivo for the first time. In this review we summarise metabolism in the healthy and diseased heart, give an introduction to the hyperpolarisation technique, 'dynamic nuclear polarisation' (DNP), and review the preclinical studies that have thus far explored healthy cardiac metabolism and different models of human heart disease. We furthermore show what advances have been made to translate this technique into the clinic, what technical challenges still remain and what unmet clinical needs and unexplored metabolic substrates still need to be assessed by researchers in this exciting and fast-moving field.
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Affiliation(s)
- Kerstin N Timm
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK.
| | - Jack J Miller
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK; Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, UK; Clarendon Laboratory, Department of Physics, University of Oxford, UK.
| | - John A Henry
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK.
| | - Damian J Tyler
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK; Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, UK.
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8
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Combined hyperpolarized 13C-pyruvate MRS and 18F-FDG PET (hyperPET) estimates of glycolysis in canine cancer patients. Eur J Radiol 2018; 103:6-12. [PMID: 29803387 DOI: 10.1016/j.ejrad.2018.02.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 02/13/2018] [Accepted: 02/24/2018] [Indexed: 01/13/2023]
Abstract
13C Magnetic Resonance Spectroscopy (MRS) using hyperpolarized 13C-labeled pyruvate as a substrate offers a measure of pyruvate-lactate interconversion and is thereby a marker of the elevated aerobic glycolysis (Warburg effect) generally exhibited by cancer cells. Here, we aim to compare hyperpolarized [1-13C]pyruvate MRS with simultaneous 18F-2-fluoro-2-deoxy-d-glucose (FDG) PET in a cross-sectional study of canine cancer patients. METHODS Canine cancer patients underwent integrated PET/MRI using a clinical whole-body system. Hyperpolarized [1-13C]pyruvate was obtained using dissolution-DNP. 18F-FDG PET, dynamic 13C MRS, 13C MRS Imaging (MRSI) and anatomical 1H MRI was acquired from 17 patients. Apparent pyruvate-to-lactate rate constants were estimated from dynamic 13C MRS. 18F-FDG Standard Uptake Values and maximum [1-13C]lactate-to-total-13C ratios were obtained from tumor regions of interest. Following inspection of data, patients were grouped according to main cancer type and linear regression between measures of lactate generation and 18F-FDG uptake were tested within groups. Between groups, the same measures were tested for group differences. RESULTS The main cancer types of the 17 patients were sarcoma (n = 11), carcinoma (n = 5) and mastocytoma (n = 1). Significant correlations between pyruvate-to-lactate rate constants and 18F-FDG uptake were found for sarcoma patients, whereas no significant correlations appeared for carcinoma patients. The sarcoma patients showed a non-significant trend towards lower 18F-FDG uptake and higher lactate generation than carcinoma patients. However, the ratio of lactate generation to 18F-FDG uptake was found to be significantly higher in sarcoma as compared to carcinoma. The results were found both when lactate generation was estimated as an apparent pyruvate-to-lactate rate constant from dynamic 13C MRS and as an [1-13C]lactate to total 13C ratio from 13C MRSI. CONCLUSIONS A comparison of hyperpolarized [1-13C]pyruvate MRS with simultaneous 18F-FDG PET indicate that lactate generation and 18F-FDG uptake in cancers can be related and that their relation depend on cancer type. This finding could be important for the interpretation and eventual clinical implementation of hyperpolarized 13C. In addition, the differences between the two modalities may allow for better metabolic phenotyping performing hybrid imaging in the form of hyperPET.
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Rahbek S, Gutte H, Johannesen HH, Koch J, Jensen LK, Dich-Jorgensen K, Jensen HE, Hansen AE, Kjaer A. Hyperpolarized 13C-MRSI and PET (hyperPET) in an Osteomyelitis Pig Model: A Pilot Study. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2017. [DOI: 10.1109/tns.2016.2642478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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