RT Journal Article
SR Electronic
T1 Clinical Translation of Hyperpolarized <sup>13</sup>C Metabolic Probes for Glioma Imaging
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP ajnr.A8726
DO 10.3174/ajnr.A8726
A1 Autry, Adam W.
A1 Kim, Yaewon
A1 Dang, Duy
A1 Chen, Hsin-Yu
A1 Slater, James B.
A1 Bok, Robert A.
A1 Xu, Duan
A1 Lupo, Janine M.
A1 Gordon, Jeremy W.
A1 Larson, Peder E.Z.
A1 Vigneron, Daniel B.
A1 Li, Yan
A1 Chang, Susan M.
YR 2025
UL http://www.ajnr.org/content/early/2025/03/05/ajnr.A8726.abstract
AB Hyperpolarized carbon-13 (HP-13C) MRI enables the real-time measurement of dynamic metabolism by utilizing molecular probes whose magnetization has been transiently enhanced via dynamic nuclear polarization of 13C labels. Based on pre-clinical and clinical investigations demonstrating Warburg-related metabolic dysfunction and tricarboxylic acid (TCA)-cycle alterations in gliomas, HP13C techniques appear very promising for overcoming conventional challenges to evaluating tumor burden and extent, early therapeutic response and progression among patients non-invasively. This article surveys the multi-faceted translational development of HP-13C MRI in the context of glioma imaging, while emphasizing innovation concerning the pharmacy production of HP probes – [1-13C]/[2-13C]-pyruvate and [1-13C,5-12C]-alpha-ketoglutarate – that serve as non-radioactive metabolic contrast agents. Borrowing from practical experience, we present specific probe indications for isocitrate dehydrogenase (IDH)-wildtype glioblastomas and IDH-mutant gliomas together with example data to show the targeted, pathway-dependent function of these agents and their utility. Additional information pertaining to HP-13C hardware, acquisition and post-processing techniques provides an overview of the imaging methodology as it is currently performed at a leading institution. Considering the developing markers for progressive disease in glioblastomas and rapidly advancing capability, this unique imaging technology appears poised for translational impact following further evaluation.ABBREVIATIONS: 2-HG = D-2-hydroxyglutarate; α-KG = alpha-ketoglutarate; CSI = chemical shift imaging; d-DNP = dissolution-dynamic nuclear polarization; EPI = echo-planar imaging; EPSI = echo-planar spectroscopic imaging; IDHm = isocitrate dehydrogenasemutant; IR-SPGR = inversion recovery-prepared fast spoiled gradient-recalled (imaging); LrGGs = lower-grade gliomas; NMR = nuclear magnetic resonance; OGC = oxoglutarate carrier; PHIP = parahydrogen-induced polarization; SNR = signal-to-noise ratio; TCA cycle = tricarboxylic acid cycle; WHO = World Health Organization.