Clinical Translation of Hyperpolarized 13 C Metabolic Probes for Glioma Imaging

作者：Adam W. Autry, Yaewon Kim, Duy Dang, Hsin-Yu Chen, James B. Slater, Robert Bok, Xu Duan, Janine Lupo, Jeremy W. Gordon, Peder E.Z. Larson, Daniel B. Vigneron, Yan Li, Susan M. Chang · 发表于：American Journal of Neuroradiology · 年份：2025 · DOI：10.3174/ajnr.a8726 · 被引用次数：8 · 研究领域：Advanced NMR Techniques and Applications、Advanced MRI Techniques and Applications、Medical Imaging Techniques and Applications

ABSTRACT Hyperpolarized carbon-13 (HP- 13 C) MRI enables the real-time measurement of dynamic metabolism by utilizing molecular probes whose magnetization has been transiently enhanced via dynamic nuclear polarization of 13 C labels. Based on pre-clinical and clinical investigations demonstrating Warburg-related metabolic dysfunction and tricarboxylic acid (TCA)-cycle alterations in gliomas, HP 13 C 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- 13 C MRI in the context of glioma imaging, while emphasizing innovation concerning the pharmacy production of HP probes – [1- 13 C]/[2- 13 C]-pyruvate and [1- 13 C,5- 12 C]-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- 13 C 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 un...