1
|
Larson PEZ, Bernard JML, Bankson JA, Bøgh N, Bok RA, Chen AP, Cunningham CH, Gordon J, Hövener JB, Laustsen C, Mayer D, McLean MA, Schilling F, Slater J, Vanderheyden JL, von Morze C, Vigneron DB, Xu D. Current methods for hyperpolarized [1- 13C]pyruvate MRI human studies. Magn Reson Med 2024; 91:2204-2228. [PMID: 38441968 PMCID: PMC10997462 DOI: 10.1002/mrm.29875] [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: 05/13/2023] [Revised: 08/12/2023] [Accepted: 09/06/2023] [Indexed: 03/07/2024]
Abstract
MRI with hyperpolarized (HP) 13C agents, also known as HP 13C MRI, can measure processes such as localized metabolism that is altered in numerous cancers, liver, heart, kidney diseases, and more. It has been translated into human studies during the past 10 years, with recent rapid growth in studies largely based on increasing availability of HP agent preparation methods suitable for use in humans. This paper aims to capture the current successful practices for HP MRI human studies with [1-13C]pyruvate-by far the most commonly used agent, which sits at a key metabolic junction in glycolysis. The paper is divided into four major topic areas: (1) HP 13C-pyruvate preparation; (2) MRI system setup and calibrations; (3) data acquisition and image reconstruction; and (4) data analysis and quantification. In each area, we identified the key components for a successful study, summarized both published studies and current practices, and discuss evidence gaps, strengths, and limitations. This paper is the output of the "HP 13C MRI Consensus Group" as well as the ISMRM Hyperpolarized Media MR and Hyperpolarized Methods and Equipment study groups. It further aims to provide a comprehensive reference for future consensus, building as the field continues to advance human studies with this metabolic imaging modality.
Collapse
Affiliation(s)
- Peder EZ Larson
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley, CA
94143, USA
| | - Jenna ML Bernard
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | - James A Bankson
- Department of Imaging Physics, MD Anderson Medical Center,
Houston, TX, USA
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | | | - Charles H Cunningham
- Physical Sciences, Sunnybrook Research Institute, Toronto,
Ontario, Canada
- Department of Medical Biophysics, University of Toronto,
Toronto, Ontario, Canada
| | - Jeremy Gordon
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North
Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University
Medical Center Schleswig-Holstein (UKSH), Kiel University, Am Botanischen Garten 14,
24118, Kiel, Germany
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
| | - Dirk Mayer
- Department of Diagnostic Radiology and Nuclear Medicine,
University of Maryland School of Medicine, Baltimore, MD, USA
- Greenebaum Cancer Center, University of Maryland School
of Medicine, Baltimore, MD, USA
| | - Mary A McLean
- Department of Radiology, University of Cambridge,
Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of
Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
| | - Franz Schilling
- Department of Nuclear Medicine, School of Medicine,
Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich,
Germany
| | - James Slater
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | | | | | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley, CA
94143, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley, CA
94143, USA
| | | |
Collapse
|
2
|
Sahin S, Garnæs MF, Bennett A, Dwork N, Tang S, Liu X, Vaidya M, Wang ZJ, Larson PEZ. A pharmacokinetic model for hyperpolarized 13C-pyruvate MRI when using metabolite-specific bSSFP sequences. Magn Reson Med 2024. [PMID: 38775035 DOI: 10.1002/mrm.30142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Metabolite-specific balanced SSFP (MS-bSSFP) sequences are increasingly used in hyperpolarized [1-13C]Pyruvate (HP 13C) MRI studies as they improve SNR by refocusing the magnetization each TR. Currently, pharmacokinetic models used to fit conversion rate constants, kPL and kPB, and rate constant maps do not account for differences in the signal evolution of MS-bSSFP acquisitions. METHODS In this work, a flexible MS-bSSFP model was built that can be used to fit conversion rate constants for these experiments. The model was validated in vivo using paired animal (healthy rat kidneys n = 8, transgenic adenocarcinoma of the mouse prostate n = 3) and human renal cell carcinoma (n = 3) datasets. Gradient echo (GRE) acquisitions were used with a previous GRE model to compare to the results of the proposed GRE-bSSFP model. RESULTS Within simulations, the proposed GRE-bSSFP model fits the simulated data well, whereas a GRE model shows bias because of model mismatch. For the in vivo datasets, the estimated conversion rate constants using the proposed GRE-bSSFP model are consistent with a previous GRE model. Jointly fitting the lactate T2 with kPL resulted in less precise kPL estimates. CONCLUSION The proposed GRE-bSSFP model provides a method to estimate conversion rate constants, kPL and kPB, for MS-bSSFP HP 13C experiments. This model may also be modified and used for other applications, for example, estimating rate constants with other hyperpolarized reagents or multi-echo bSSFP.
Collapse
Affiliation(s)
- Sule Sahin
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
- Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | | | - Anna Bennett
- Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Nicholas Dwork
- Biomedical Informatics and Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Xiaoxi Liu
- Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Manushka Vaidya
- Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Zhen Jane Wang
- Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Peder E Z Larson
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
- Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| |
Collapse
|
3
|
Agarwal S, Gordon J, Bok RA, von Morze C, Vigneron DB, Kurhanewicz J, Ohliger MA. Distinguishing metabolic signals of liver tumors from surrounding liver cells using hyperpolarized 13 C MRI and gadoxetate. Magn Reson Med 2024; 91:2114-2125. [PMID: 38270193 DOI: 10.1002/mrm.29918] [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: 01/10/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 01/26/2024]
Abstract
PURPOSE To use the hepatocyte-specific gadolinium-based contrast agent gadoxetate combined with hyperpolarized (HP) [1-13 C]pyruvate MRI to selectively suppress metabolic signals from normal hepatocytes while preserving the signals arising from tumors. METHODS Simulations were performed to determine the expected changes in HP 13 C MR signal in liver and tumor under the influence of gadoxetate. CC531 colon cancer cells were implanted into the livers of five Wag/Rij rats. Liver and tumor metabolism were imaged at 3 T using HP [1-13 C] pyruvate chemical shift imaging before and 15 min after injection of gadoxetate. Area under the curve for pyruvate and lactate were measured from voxels containing at least 75% of normal-appearing liver or tumor. RESULTS Numerical simulations predicted a 36% decrease in lactate-to-pyruvate (L/P) ratio in liver and 16% decrease in tumor. In vivo, baseline L/P ratio was 0.44 ± 0.25 in tumors versus 0.21 ± 0.08 in liver (p = 0.09). Following administration of gadoxetate, mean L/P ratio decreased by an average of 0.11 ± 0.06 (p < 0.01) in normal-appearing liver. In tumors, mean L/P ratio post-gadoxetate did not show a statistically significant change from baseline. Compared to baseline levels, the relative decrease in L/P ratio was significantly greater in liver than in tumors (-0.52 ± 0.16 vs. -0.19 ± 0.25, p < 0.05). CONCLUSIONS The intracellular hepatobiliary contrast agent showed a greater effect suppressing HP 13 C MRI metabolic signals (through T1 shortening) in normal-appearing liver when compared to tumors. The combined use of HP MRI with selective gadolinium contrast agents may allow more selective imaging in HP 13 C MRI.
Collapse
Affiliation(s)
- Shubhangi Agarwal
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Jeremy Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Cornelius von Morze
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Liver Center, University of California, San Francisco, San Francisco, California, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Michael A Ohliger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Liver Center, University of California, San Francisco, San Francisco, California, USA
- Department of Radiology, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| |
Collapse
|
4
|
Nickles TM, Kim Y, Lee PM, Chen HY, Ohliger M, Bok RA, Wang ZJ, Larson PEZ, Vigneron DB, Gordon JW. Hyperpolarized 13 C metabolic imaging of the human abdomen with spatiotemporal denoising. Magn Reson Med 2024; 91:2153-2161. [PMID: 38193310 PMCID: PMC10950515 DOI: 10.1002/mrm.29985] [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: 07/14/2023] [Revised: 10/27/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE Improving the quality and maintaining the fidelity of large coverage abdominal hyperpolarized (HP) 13 C MRI studies with a patch based global-local higher-order singular value decomposition (GL-HOVSD) spatiotemporal denoising approach. METHODS Denoising performance was first evaluated using the simulated [1-13 C]pyruvate dynamics at different noise levels to determine optimal kglobal and klocal parameters. The GL-HOSVD spatiotemporal denoising method with the optimized parameters was then applied to two HP [1-13 C]pyruvate EPI abdominal human cohorts (n = 7 healthy volunteers and n = 8 pancreatic cancer patients). RESULTS The parameterization of kglobal = 0.2 and klocal = 0.9 denoises abdominal HP data while retaining image fidelity when evaluated by RMSE. The kPX (conversion rate of pyruvate-to-metabolite, X = lactate or alanine) difference was shown to be <20% with respect to ground-truth metabolic conversion rates when there is adequate SNR (SNRAUC > 5) for downstream metabolites. In both human cohorts, there was a greater than nine-fold gain in peak [1-13 C]pyruvate, [1-13 C]lactate, and [1-13 C]alanine apparent SNRAUC . The improvement in metabolite SNR enabled a more robust quantification of kPL and kPA . After denoising, we observed a 2.1 ± 0.4 and 4.8 ± 2.5-fold increase in the number of voxels reliably fit across abdominal FOVs for kPL and kPA quantification maps. CONCLUSION Spatiotemporal denoising greatly improves visualization of low SNR metabolites particularly [1-13 C]alanine and quantification of [1-13 C]pyruvate metabolism in large FOV HP 13 C MRI studies of the human abdomen.
Collapse
Affiliation(s)
- Tanner M Nickles
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California, USA
| | - Yaewon Kim
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Philip M Lee
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Michael Ohliger
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Robert A Bok
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Zhen J Wang
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California, USA
| | - Peder E Z Larson
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California, USA
| | - Daniel B Vigneron
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California, USA
| |
Collapse
|
5
|
Lai YC, Hsieh CY, Juan YH, Lu KY, Lee HJ, Ng SH, Wan YL, Lin G. Hyperpolarized Carbon-13 Magnetic Resonance Imaging: Technical Considerations and Clinical Applications. Korean J Radiol 2024; 25:459-472. [PMID: 38685736 PMCID: PMC11058429 DOI: 10.3348/kjr.2024.0069] [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: 01/18/2024] [Revised: 02/17/2024] [Accepted: 02/27/2024] [Indexed: 05/02/2024] Open
Abstract
Hyperpolarized (HP) carbon-13 (13C) MRI represents an innovative approach for noninvasive, real-time assessment of dynamic metabolic flux, with potential integration into routine clinical MRI. The use of [1-13C]pyruvate as a probe and its conversion to [1-13C]lactate constitute an extensively explored metabolic pathway. This review comprehensively outlines the establishment of HP 13C-MRI, covering multidisciplinary team collaboration, hardware prerequisites, probe preparation, hyperpolarization techniques, imaging acquisition, and data analysis. This article discusses the clinical applications of HP 13C-MRI across various anatomical domains, including the brain, heart, skeletal muscle, breast, liver, kidney, pancreas, and prostate. Each section highlights the specific applications and findings pertinent to these regions, emphasizing the potential versatility of HP 13C-MRI in diverse clinical contexts. This review serves as a comprehensive update, bridging technical aspects with clinical applications and offering insights into the ongoing advancements in HP 13C-MRI.
Collapse
Affiliation(s)
- Ying-Chieh Lai
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ching-Yi Hsieh
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Research Center for Radiation Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hsiang Juan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Ying Lu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsien-Ju Lee
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Yung-Liang Wan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Research Center for Radiation Medicine, Chang Gung University, Taoyuan, Taiwan.
| |
Collapse
|
6
|
Lin G, Hsieh CY, Lai YC, Wang CC, Lin Y, Lu KY, Chai WY, Chen AP, Yen TC, Ng SH, Lai CH. Hyperpolarized [1- 13C]-pyruvate MRS evaluates immune potential and predicts response to radiotherapy in cervical cancer. Eur Radiol Exp 2024; 8:46. [PMID: 38594558 PMCID: PMC11003947 DOI: 10.1186/s41747-024-00445-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/23/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Monitoring pyruvate metabolism in the spleen is important for assessing immune activity and achieving successful radiotherapy for cervical cancer due to the significance of the abscopal effect. We aimed to explore the feasibility of utilizing hyperpolarized (HP) [1-13C]-pyruvate magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) to evaluate pyruvate metabolism in the human spleen, with the aim of identifying potential candidates for radiotherapy in cervical cancer. METHODS This prospective study recruited six female patients with cervical cancer (median age 55 years; range 39-60) evaluated using HP [1-13C]-pyruvate MRI/MRS at baseline and 2 weeks after radiotherapy. Proton (1H) diffusion-weighted MRI was performed in parallel to estimate splenic cellularity. The primary outcome was defined as tumor response to radiotherapy. The Student t-test was used for comparing 13C data between the groups. RESULTS The splenic HP [1-13C]-lactate-to-total carbon (tC) ratio was 5.6-fold lower in the responders than in the non-responders at baseline (p = 0.009). The splenic [1-13C]-lactate-to-tC ratio revealed a 1.7-fold increase (p = 0.415) and the splenic [1-13C]-alanine-to-tC ratio revealed a 1.8-fold increase after radiotherapy (p = 0.482). The blood leukocyte differential count revealed an increased proportion of neutrophils two weeks following treatment, indicating enhanced immune activity (p = 0.013). The splenic apparent diffusion coefficient values between the groups were not significantly different. CONCLUSIONS This exploratory study revealed the feasibility of HP [1-13C]-pyruvate MRS of the spleen for evaluating baseline immune potential, which was associated with clinical outcomes of cervical cancer after radiotherapy. TRIAL REGISTRATION ClinicalTrials.gov NCT04951921 , registered 7 July 2021. RELEVANCE STATEMENT This prospective study revealed the feasibility of using HP 13C MRI/MRS for assessing pyruvate metabolism of the spleen to evaluate the patients' immune potential that is associated with radiotherapeutic clinical outcomes in cervical cancer. KEY POINTS • Effective radiotherapy induces abscopal effect via altering immune metabolism. • Hyperpolarized 13C MRS evaluates patients' immune potential non-invasively. • Pyruvate-to-lactate conversion in the spleen is elevated following radiotherapy.
Collapse
Affiliation(s)
- Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St, Guishan, 33382, Taoyuan, Taiwan.
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan.
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
- Research Center for Radiation Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Ching-Yi Hsieh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St, Guishan, 33382, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Research Center for Radiation Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ying-Chieh Lai
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St, Guishan, 33382, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chun-Chieh Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Research Center for Radiation Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yenpo Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St, Guishan, 33382, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Kuan-Ying Lu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St, Guishan, 33382, Taoyuan, Taiwan
- Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wen-Yen Chai
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St, Guishan, 33382, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | | | - Tzu-Chen Yen
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, 5 Fuhsing St, Guishan, 33382, Taoyuan, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chyong-Huey Lai
- Division of Gynecologic Oncology, Gynecologic Oncology Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
| |
Collapse
|
7
|
Chaumeil MM, Bankson JA, Brindle KM, Epstein S, Gallagher FA, Grashei M, Guglielmetti C, Kaggie JD, Keshari KR, Knecht S, Laustsen C, Schmidt AB, Vigneron D, Yen YF, Schilling F. New Horizons in Hyperpolarized 13C MRI. Mol Imaging Biol 2024; 26:222-232. [PMID: 38147265 PMCID: PMC10972948 DOI: 10.1007/s11307-023-01888-5] [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: 09/20/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/27/2023]
Abstract
Hyperpolarization techniques significantly enhance the sensitivity of magnetic resonance (MR) and thus present fascinating new directions for research and applications with in vivo MR imaging and spectroscopy (MRI/S). Hyperpolarized 13C MRI/S, in particular, enables real-time non-invasive assessment of metabolic processes and holds great promise for a diverse range of clinical applications spanning fields like oncology, neurology, and cardiology, with a potential for improving early diagnosis of disease, patient stratification, and therapy response assessment. Despite its potential, technical challenges remain for achieving clinical translation. This paper provides an overview of the discussions that took place at the international workshop "New Horizons in Hyperpolarized 13C MRI," in March 2023 at the Bavarian Academy of Sciences and Humanities, Munich, Germany. The workshop covered new developments, as well as future directions, in topics including polarization techniques (particularly focusing on parahydrogen-based methods), novel probes, considerations related to data acquisition and analysis, and emerging clinical applications in oncology and other fields.
Collapse
Affiliation(s)
- Myriam M Chaumeil
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA.
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
| | - James A Bankson
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | | | - Ferdia A Gallagher
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Martin Grashei
- Department of Nuclear Medicine, TUM School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Caroline Guglielmetti
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Joshua D Kaggie
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Kayvan R Keshari
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
- Weill Cornell Graduate School, New York City, NY, USA
| | | | - Christoffer Laustsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
| | - Andreas B Schmidt
- Partner Site Freiburg and German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5a, 79106, Freiburg, Germany
- Department of Chemistry, Integrative Biosciences (Ibio), Karmanos Cancer Institute (KCI), Wayne State University, Detroit, MI, 48202, USA
| | - Daniel Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Yi-Fen Yen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Franz Schilling
- Department of Nuclear Medicine, TUM School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
- Partner Site Freiburg and German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| |
Collapse
|
8
|
Liu X, Cui D, Xu D, Bok R, Wang ZJ, Vigneron DB, Larson PEZ, Gordon JW. Dynamic T 2 * relaxometry of hyperpolarized [1- 13 C]pyruvate MRI in the human brain and kidneys. Magn Reson Med 2024; 91:1030-1042. [PMID: 38013217 PMCID: PMC10872504 DOI: 10.1002/mrm.29942] [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: 08/14/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE This study aimed to quantifyT 2 * $$ {T}_2^{\ast } $$ for hyperpolarized [1-13 C]pyruvate and metabolites in the healthy human brain and renal cell carcinoma (RCC) patients at 3 T. METHODS DynamicT 2 * $$ {T}_2^{\ast } $$ values were measured with a metabolite-specific multi-echo spiral sequence. The dynamicT 2 * $$ {T}_2^{\ast } $$ of [1-13 C]pyruvate, [1-13 C]lactate, and 13 C-bicarbonate was estimated in regions of interest in the whole brain, sinus vein, gray matter, and white matter in healthy volunteers, as well as in kidney tumors and the contralateral healthy kidneys in a separate group of RCC patients.T 2 * $$ {T}_2^{\ast } $$ was fit using a mono-exponential function; and metabolism was quantified using pyruvate-to-lactate conversion rate maps and lactate-to-pyruvate ratio maps, which were compared with and without an estimatedT 2 * $$ {T}_2^{\ast } $$ correction. RESULTS TheT 2 * $$ {T}_2^{\ast } $$ of pyruvate was shown to vary during the acquisition, whereas theT 2 * $$ {T}_2^{\ast } $$ of lactate and bicarbonate were relatively constant through time and across the organs studied. TheT 2 * $$ {T}_2^{\ast } $$ of lactate was similar in gray matter (29.75 ± 1.04 ms), white matter (32.89 ± 0.9 ms), healthy kidney (34.61 ± 4.07 ms), and kidney tumor (33.01 ± 2.31 ms); and theT 2 * $$ {T}_2^{\ast } $$ of bicarbonate was different between whole-brain (108.17 ± 14.05 ms) and healthy kidney (58.45 ± 6.63 ms). TheT 2 * $$ {T}_2^{\ast } $$ of pyruvate had similar trends in both brain and RCC studies, reducing from 75.56 ± 2.23 ms to 22.24 ± 1.24 ms in the brain and reducing from 122.72 ± 9.86 ms to 57.38 ± 7.65 ms in the kidneys. CONCLUSION Multi-echo dynamic imaging can quantifyT 2 * $$ {T}_2^{\ast } $$ and metabolism in a single integrated acquisition. Clear differences were observed in theT 2 * $$ {T}_2^{\ast } $$ of metabolites and in their behavior throughout the timecourse.
Collapse
Affiliation(s)
- Xiaoxi Liu
- Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Di Cui
- Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Duan Xu
- Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Robert Bok
- Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Zhen J Wang
- Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Daniel B Vigneron
- Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, California, USA
| | - Peder E Z Larson
- Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, California, USA
| | - Jeremy W Gordon
- Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
9
|
Dou Q, Grant AK, Coutinto de Souza P, Moussa M, Nasser I, Ahmed M, Tsai LL. Characterizing Metabolic Heterogeneity of Hepatocellular Carcinoma with Hyperpolarized 13C Pyruvate MRI and Mass Spectrometry. Radiol Imaging Cancer 2024; 6:e230056. [PMID: 38426887 PMCID: PMC10988335 DOI: 10.1148/rycan.230056] [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: 04/27/2023] [Revised: 12/16/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024]
Abstract
Purpose To characterize the metabolomic profiles of two hepatocellular carcinoma (HCC) rat models, track evolution of these profiles to a stimulated tumor state, and assess their effect on lactate flux with hyperpolarized (HP) carbon 13 (13C) MRI. Materials and Methods Forty-three female adult Fischer rats were implanted with N1S1 or McA-RH7777 HCC tumors. In vivo lactate-to-pyruvate ratio (LPR) was measured with HP 13C MRI at 9.4 T. Ex vivo mass spectrometry was used to measure intratumoral metabolites, and Ki67 labeling was used to quantify proliferation. Tumors were first compared with three normal liver controls. The tumors were then compared with stimulated variants via off-target hepatic thermal ablation treatment. All comparisons were made using the Mann-Whitney test. Results HP 13C pyruvate MRI showed greater LPR in N1S1 tumors compared with normal liver (mean [SD], 0.564 ± 0.194 vs 0.311 ± 0.057; P < .001 [n = 9]), but not for McA-RH7777 (P = .44 [n = 8]). Mass spectrometry confirmed that the glycolysis pathway was increased in N1S1 tumors and decreased in McA-RH7777 tumors. The pentose phosphate pathway was also decreased only in McA-RH7777 tumors. Increased proliferation in stimulated N1S1 tumors corresponded to a net increase in LPR (six stimulated vs six nonstimulated, 0.269 ± 0.148 vs 0.027 ± 0.08; P = .009), but not in McA-RH7777 (eight stimulated vs six nonstimulated, P = .13), despite increased proliferation and metastases. Mass spectrometry demonstrated relatively increased lactate production with stimulation in N1S1 tumors only. Conclusion Two HCC subtypes showed divergent glycolytic dependency at baseline and during transformation to a high proliferation state. This metabolic heterogeneity in HCC should be considered with use of HP 13C MRI for diagnosis and tracking. Keywords: Molecular Imaging-Probe Development, Liver, Abdomen/GI, Oncology, Hepatocellular Carcinoma © RSNA, 2024 See also commentary by Ohliger in this issue.
Collapse
Affiliation(s)
- Qianhui Dou
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Aaron K. Grant
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Patricia Coutinto de Souza
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Marwan Moussa
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Imad Nasser
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Muneeb Ahmed
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| | - Leo L. Tsai
- From the Departments of Radiology (Q.D., A.K.G., M.M., M.A., L.L.T.)
and Pathology (I.N.), Beth Israel Deaconess Medical Center, Harvard Medical
School, 330 Brookline Ave, ANSIN 230, Boston, MA 02215; and Merck & Co,
Rahway, NJ (P.C.d.S.)
| |
Collapse
|
10
|
Autry AW, Vaziri S, Gordon JW, Chen HY, Kim Y, Dang D, LaFontaine M, Noeske R, Bok R, Villanueva-Meyer JE, Clarke JL, Oberheim Bush NA, Chang SM, Xu D, Lupo JM, Larson PEZ, Vigneron DB, Li Y. Advanced Hyperpolarized 13C Metabolic Imaging Protocol for Patients with Gliomas: A Comprehensive Multimodal MRI Approach. Cancers (Basel) 2024; 16:354. [PMID: 38254844 PMCID: PMC10814348 DOI: 10.3390/cancers16020354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
This study aimed to implement a multimodal 1H/HP-13C imaging protocol to augment the serial monitoring of patients with glioma, while simultaneously pursuing methods for improving the robustness of HP-13C metabolic data. A total of 100 1H/HP [1-13C]-pyruvate MR examinations (104 HP-13C datasets) were acquired from 42 patients according to the comprehensive multimodal glioma imaging protocol. Serial data coverage, accuracy of frequency reference, and acquisition delay were evaluated using a mixed-effects model to account for multiple exams per patient. Serial atlas-based HP-13C MRI demonstrated consistency in volumetric coverage measured by inter-exam dice coefficients (0.977 ± 0.008, mean ± SD; four patients/11 exams). The atlas-derived prescription provided significantly improved data quality compared to manually prescribed acquisitions (n = 26/78; p = 0.04). The water-based method for referencing [1-13C]-pyruvate center frequency significantly reduced off-resonance excitation relative to the coil-embedded [13C]-urea phantom (4.1 ± 3.7 Hz vs. 9.9 ± 10.7 Hz; p = 0.0007). Significantly improved capture of tracer inflow was achieved with the 2-s versus 5-s HP-13C MRI acquisition delay (p = 0.007). This study demonstrated the implementation of a comprehensive multimodal 1H/HP-13C MR protocol emphasizing the monitoring of steady-state/dynamic metabolism in patients with glioma.
Collapse
Affiliation(s)
- Adam W. Autry
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Sana Vaziri
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Duy Dang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Marisa LaFontaine
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | | | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Javier E. Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Jennifer L. Clarke
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Nancy Ann Oberheim Bush
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Susan M. Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Janine M. Lupo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Peder E. Z. Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| |
Collapse
|
11
|
Wodtke P, Grashei M, Schilling F. Quo Vadis Hyperpolarized 13C MRI? Z Med Phys 2023:S0939-3889(23)00120-4. [PMID: 38160135 DOI: 10.1016/j.zemedi.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 01/03/2024]
Abstract
Over the last two decades, hyperpolarized 13C MRI has gained significance in both preclinical and clinical studies, hereby relying on technologies like PHIP-SAH (ParaHydrogen-Induced Polarization-Side Arm Hydrogenation), SABRE (Signal Amplification by Reversible Exchange), and dDNP (dissolution Dynamic Nuclear Polarization), with dDNP being applied in humans. A clinical dDNP polarizer has enabled studies across 24 sites, despite challenges like high cost and slow polarization. Parahydrogen-based techniques like SABRE and PHIP offer faster, more cost-efficient alternatives but require molecule-specific optimization. The focus has been on imaging metabolism of hyperpolarized probes, which requires long T1, high polarization and rapid contrast generation. Efforts to establish novel probes, improve acquisition techniques and enhance data analysis methods including artificial intelligence are ongoing. Potential clinical value of hyperpolarized 13C MRI was demonstrated primarily for treatment response assessment in oncology, but also in cardiology, nephrology, hepatology and CNS characterization. In this review on biomedical hyperpolarized 13C MRI, we summarize important and recent advances in polarization techniques, probe development, acquisition and analysis methods as well as clinical trials. Starting from those we try to sketch a trajectory where the field of biomedical hyperpolarized 13C MRI might go.
Collapse
Affiliation(s)
- Pascal Wodtke
- Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany; Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge UK
| | - Martin Grashei
- Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany
| | - Franz Schilling
- Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany; Munich Institute of Biomedical Engineering, Technical University of Munich, 85748 Garching, Germany; German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany.
| |
Collapse
|
12
|
Larson PE, Bernard JM, Bankson JA, Bøgh N, Bok RA, Chen AP, Cunningham CH, Gordon J, Hövener JB, Laustsen C, Mayer D, McLean MA, Schilling F, Slater J, Vanderheyden JL, von Morze C, Vigneron DB, Xu D, Group THCMC. Current Methods for Hyperpolarized [1-13C]pyruvate MRI Human Studies. ARXIV 2023:arXiv:2309.04040v2. [PMID: 37731660 PMCID: PMC10508833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
MRI with hyperpolarized (HP) 13C agents, also known as HP 13C MRI, can measure processes such as localized metabolism that is altered in numerous cancers, liver, heart, kidney diseases, and more. It has been translated into human studies during the past 10 years, with recent rapid growth in studies largely based on increasing availability of hyperpolarized agent preparation methods suitable for use in humans. This paper aims to capture the current successful practices for HP MRI human studies with [1-13C]pyruvate - by far the most commonly used agent, which sits at a key metabolic junction in glycolysis. The paper is divided into four major topic areas: (1) HP 13C-pyruvate preparation, (2) MRI system setup and calibrations, (3) data acquisition and image reconstruction, and (4) data analysis and quantification. In each area, we identified the key components for a successful study, summarized both published studies and current practices, and discuss evidence gaps, strengths, and limitations. This paper is the output of the HP 13C MRI Consensus Group as well as the ISMRM Hyperpolarized Media MR and Hyperpolarized Methods & Equipment study groups. It further aims to provide a comprehensive reference for future consensus building as the field continues to advance human studies with this metabolic imaging modality.
Collapse
|
13
|
Jha PK, Walker C, Mitchell D, Oden JT, Schellingerhout D, Bankson JA, Fuentes DT. Mutual-information based optimal experimental design for hyperpolarized [Formula: see text]C-pyruvate MRI. Sci Rep 2023; 13:18047. [PMID: 37872226 PMCID: PMC10593962 DOI: 10.1038/s41598-023-44958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023] Open
Abstract
A key parameter of interest recovered from hyperpolarized (HP) MRI measurements is the apparent pyruvate-to-lactate exchange rate, [Formula: see text], for measuring tumor metabolism. This manuscript presents an information-theory-based optimal experimental design approach that minimizes the uncertainty in the rate parameter, [Formula: see text], recovered from HP-MRI measurements. Mutual information is employed to measure the information content of the HP measurements with respect to the first-order exchange kinetics of the pyruvate conversion to lactate. Flip angles of the pulse sequence acquisition are optimized with respect to the mutual information. A time-varying flip angle scheme leads to a higher parameter optimization that can further improve the quantitative value of mutual information over a constant flip angle scheme. However, the constant flip angle scheme, 35 and 28 degrees for pyruvate and lactate measurements, leads to an accuracy and precision comparable to the variable flip angle schemes obtained from our method. Combining the comparable performance and practical implementation, optimized pyruvate and lactate flip angles of 35 and 28 degrees, respectively, are recommended.
Collapse
Affiliation(s)
- Prashant K. Jha
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712 USA
| | - Christopher Walker
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX 77320 USA
| | - Drew Mitchell
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX 77320 USA
| | - J. Tinsley Oden
- Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX 78712 USA
| | | | - James A. Bankson
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX 77320 USA
| | - David T. Fuentes
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX 77320 USA
| |
Collapse
|
14
|
Liu X, Tang S, Cui D, Bok RA, Chen HY, Gordon JW, Wang ZJ, Larson PEZ. A metabolite specific 3D stack-of-spirals bSSFP sequence for improved bicarbonate imaging in hyperpolarized [1- 13C]Pyruvate MRI. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2023; 353:107518. [PMID: 37402333 PMCID: PMC10498937 DOI: 10.1016/j.jmr.2023.107518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/06/2023]
Abstract
13C-bicarbonate is a crucial measure of pyruvate oxidation and TCA cycle flux, but is challenging to measure due to its relatively low concentration and thus will greatly benefit from improved signal-to-noise ratio (SNR). To address this, we developed and investigated the feasibility of a 3D stack-of-spirals metabolite-specific balanced steady-state free precession (MS-bSSFP) sequence for improving the SNR and spatial resolution of dynamic 13C-bicarbonate imaging in hyperpolarized [1-13C]pyruvate studies. The bicarbonate MS-bSSFP sequence was evaluated by simulations, phantoms studies, preclinical studies on five rats, brain studies on two healthy volunteers and renal study on one renal cell carcinoma patient. The simulations and phantom results showed that the bicarbonate-specific pulse had minimal perturbation of other metabolites (<1%). In the animal studies, the MS-bSSFP sequence provided an approximately 2.6-3 × improvement in 13C-bicarbonate SNR compared to a metabolite-specific gradient echo (MS-GRE) sequence without altering the bicarbonate or pyruvate kinetics, and the shorter spiral readout in the MS-bSSFP approach reduced blurring. Using the SNR ratio between MS-bSSFP and MS-GRE, the T2 values of bicarbonate and lactate in the rat kidneys were estimated as 0.5 s and 1.1 s, respectively. The in-vivo feasibility of bicarbonate MS-bSSFP sequence was demonstrated in two human brain studies and one renal study. These studies demonstrate the potential of the sequence for in-vivo applications, laying the foundation for future studies to observe this relatively low concentration metabolite with high-quality images and improve measurements of pyruvate oxidation.
Collapse
Affiliation(s)
- Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | - Di Cui
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA; Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, CA, USA.
| |
Collapse
|
15
|
Sahin SI, Ji X, Agarwal S, Sinha A, Mali I, Gordon JW, Mattingly M, Subramaniam S, Kurhanewicz J, Larson PEZ, Sriram R. Metabolite-Specific Echo Planar Imaging for Preclinical Studies with Hyperpolarized 13C-Pyruvate MRI. Tomography 2023; 9:736-749. [PMID: 37104130 PMCID: PMC10143874 DOI: 10.3390/tomography9020059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 03/29/2023] Open
Abstract
Metabolite-specific echo-planar imaging (EPI) sequences with spectral–spatial (spsp) excitation are commonly used in clinical hyperpolarized [1-13C]pyruvate studies because of their speed, efficiency, and flexibility. In contrast, preclinical systems typically rely on slower spectroscopic methods, such as chemical shift imaging (CSI). In this study, a 2D spspEPI sequence was developed for use on a preclinical 3T Bruker system and tested on in vivo mice experiments with patient-derived xenograft renal cell carcinoma (RCC) or prostate cancer tissues implanted in the kidney or liver. Compared to spspEPI sequences, CSI were found to have a broader point spread function via simulations and exhibited signal bleeding between vasculature and tumors in vivo. Parameters for the spspEPI sequence were optimized using simulations and verified with in vivo data. The expected lactate SNR and pharmacokinetic modeling accuracy increased with lower pyruvate flip angles (less than 15°), intermediate lactate flip angles (25° to 40°), and temporal resolution of 3 s. Overall SNR was also higher with coarser spatial resolution (4 mm isotropic vs. 2 mm isotropic). Pharmacokinetic modelling used to fit kPL maps showed results consistent with the previous literature and across different sequences and tumor xenografts. This work describes and justifies the pulse design and parameter choices for preclinical spspEPI hyperpolarized 13C-pyruvate studies and shows superior image quality to CSI.
Collapse
Affiliation(s)
- Sule I. Sahin
- UC Berkeley—UCSF Graduate Program in Bioengineering, Berkeley, CA 94720, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
| | - Xiao Ji
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
| | - Shubhangi Agarwal
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
| | - Avantika Sinha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
| | - Ivina Mali
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
| | - Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
| | | | - Sukumar Subramaniam
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
| | - Peder E. Z. Larson
- UC Berkeley—UCSF Graduate Program in Bioengineering, Berkeley, CA 94720, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
- Correspondence: (P.E.Z.L.); (R.S.)
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94016, USA
- Correspondence: (P.E.Z.L.); (R.S.)
| |
Collapse
|
16
|
Sharma G, Maptue N, Rahim M, Trigo Mijes ML, Hever T, Wen X, Funk AM, Malloy CR, Young JD, Khemtong C. Oxidation of hyperpolarized [1- 13 C]pyruvate in isolated rat kidneys. NMR IN BIOMEDICINE 2023; 36:e4857. [PMID: 36285844 PMCID: PMC9980878 DOI: 10.1002/nbm.4857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/05/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Kidneys play a central role in numerous disorders but current imaging methods have limited utility to probe renal metabolism. Hyperpolarized (HP) 13 C magnetic resonance imaging is uniquely suited to provide metabolite-specific information about key biochemical pathways and it offers the further advantage that renal imaging is practical in humans. This study evaluated the feasibility of hyperpolarization examinations in a widely used model for analysis of renal physiology, the isolated kidney, which enables isolation of renal metabolism from the effects of other organs and validation of HP results by independent measurements. Isolated rat kidneys were supplied with either HP [1-13 C]pyruvate only or HP [1-13 C]pyruvate plus octanoate. Metabolic activity in both groups was confirmed by stable renal oxygen consumption. HP [1-13 C]pyruvate was readily metabolized to [13 C]bicarbonate, [1-13 C]lactate, and [1-13 C]alanine, detectable seconds after HP [1-13 C]pyruvate was injected. Octanoate suppressed but did not eliminate the production of HP [13 C]bicarbonate from [1-13 C]pyruvate. Steady-state flux analyses using non-HP 13 C substrates validated the utilization of HP [1-13 C]pyruvate, as observed by HP 13 C NMR. In the presence of octanoate, lactate is generated from a tricarboxylic acid cycle intermediate, oxaloacetate. The isolated rat kidney may serve as an excellent model for investigating and establishing new HP 13 C metabolic probes for future kidney imaging applications.
Collapse
Affiliation(s)
- Gaurav Sharma
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nesmine Maptue
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Mohsin Rahim
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, USA
| | - Miriam L. Trigo Mijes
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Hever
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Xiaodong Wen
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexander M. Funk
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Craig R. Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- VA North Texas Health Care System, Dallas, TX, USA
| | - Jamey D. Young
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Chalermchai Khemtong
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, USA
| |
Collapse
|
17
|
Haj-Mirzaian A, Mahmood U, Heidari P. Targeted Molecular Imaging as a Biomarker in Urologic Oncology. Urol Clin North Am 2023; 50:115-131. [PMID: 36424076 PMCID: PMC10133841 DOI: 10.1016/j.ucl.2022.09.011] [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] [Indexed: 11/23/2022]
Abstract
Urologic malignancies constitute a large portion of annually diagnosed cancers. Timely diagnosis, accurate staging, and assessment of tumor heterogeneity are essential to devising the best treatment strategy for individual patients. The high sensitivity of molecular imaging allows for early and sensitive detection of lesions that were not readily detectable using conventional imaging techniques. Moreover, molecular imaging enables the interrogation of molecular processes used in targeted cancer therapies and predicts cancer response to treatment. Here we review the current advancements in molecular imaging of urologic cancers, including prostatic, vesical, renal testicular, and ureteral cancers.
Collapse
Affiliation(s)
- Arvin Haj-Mirzaian
- Department of Radiology, Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA; Center for Precision Imaging, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA
| | - Umar Mahmood
- Department of Radiology, Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA; Center for Precision Imaging, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA.
| | - Pedram Heidari
- Department of Radiology, Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA; Center for Precision Imaging, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA
| |
Collapse
|
18
|
Eills J, Budker D, Cavagnero S, Chekmenev EY, Elliott SJ, Jannin S, Lesage A, Matysik J, Meersmann T, Prisner T, Reimer JA, Yang H, Koptyug IV. Spin Hyperpolarization in Modern Magnetic Resonance. Chem Rev 2023; 123:1417-1551. [PMID: 36701528 PMCID: PMC9951229 DOI: 10.1021/acs.chemrev.2c00534] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Magnetic resonance techniques are successfully utilized in a broad range of scientific disciplines and in various practical applications, with medical magnetic resonance imaging being the most widely known example. Currently, both fundamental and applied magnetic resonance are enjoying a major boost owing to the rapidly developing field of spin hyperpolarization. Hyperpolarization techniques are able to enhance signal intensities in magnetic resonance by several orders of magnitude, and thus to largely overcome its major disadvantage of relatively low sensitivity. This provides new impetus for existing applications of magnetic resonance and opens the gates to exciting new possibilities. In this review, we provide a unified picture of the many methods and techniques that fall under the umbrella term "hyperpolarization" but are currently seldom perceived as integral parts of the same field. Specifically, before delving into the individual techniques, we provide a detailed analysis of the underlying principles of spin hyperpolarization. We attempt to uncover and classify the origins of hyperpolarization, to establish its sources and the specific mechanisms that enable the flow of polarization from a source to the target spins. We then give a more detailed analysis of individual hyperpolarization techniques: the mechanisms by which they work, fundamental and technical requirements, characteristic applications, unresolved issues, and possible future directions. We are seeing a continuous growth of activity in the field of spin hyperpolarization, and we expect the field to flourish as new and improved hyperpolarization techniques are implemented. Some key areas for development are in prolonging polarization lifetimes, making hyperpolarization techniques more generally applicable to chemical/biological systems, reducing the technical and equipment requirements, and creating more efficient excitation and detection schemes. We hope this review will facilitate the sharing of knowledge between subfields within the broad topic of hyperpolarization, to help overcome existing challenges in magnetic resonance and enable novel applications.
Collapse
Affiliation(s)
- James Eills
- Institute
for Bioengineering of Catalonia, Barcelona
Institute of Science and Technology, 08028Barcelona, Spain,
| | - Dmitry Budker
- Johannes
Gutenberg-Universität Mainz, 55128Mainz, Germany,Helmholtz-Institut,
GSI Helmholtzzentrum für Schwerionenforschung, 55128Mainz, Germany,Department
of Physics, UC Berkeley, Berkeley, California94720, United States
| | - Silvia Cavagnero
- Department
of Chemistry, University of Wisconsin, Madison, Madison, Wisconsin53706, United States
| | - Eduard Y. Chekmenev
- Department
of Chemistry, Integrative Biosciences (IBio), Karmanos Cancer Institute
(KCI), Wayne State University, Detroit, Michigan48202, United States,Russian
Academy of Sciences, Moscow119991, Russia
| | - Stuart J. Elliott
- Molecular
Sciences Research Hub, Imperial College
London, LondonW12 0BZ, United Kingdom
| | - Sami Jannin
- Centre
de RMN à Hauts Champs de Lyon, Université
de Lyon, CNRS, ENS Lyon, Université Lyon 1, 69100Villeurbanne, France
| | - Anne Lesage
- Centre
de RMN à Hauts Champs de Lyon, Université
de Lyon, CNRS, ENS Lyon, Université Lyon 1, 69100Villeurbanne, France
| | - Jörg Matysik
- Institut
für Analytische Chemie, Universität
Leipzig, Linnéstr. 3, 04103Leipzig, Germany
| | - Thomas Meersmann
- Sir
Peter Mansfield Imaging Centre, University Park, School of Medicine, University of Nottingham, NottinghamNG7 2RD, United Kingdom
| | - Thomas Prisner
- Institute
of Physical and Theoretical Chemistry and Center of Biomolecular Magnetic
Resonance, Goethe University Frankfurt, , 60438Frankfurt
am Main, Germany
| | - Jeffrey A. Reimer
- Department
of Chemical and Biomolecular Engineering, UC Berkeley, and Materials Science Division, Lawrence Berkeley National
Laboratory, Berkeley, California94720, United States
| | - Hanming Yang
- Department
of Chemistry, University of Wisconsin, Madison, Madison, Wisconsin53706, United States
| | - Igor V. Koptyug
- International Tomography Center, Siberian
Branch of the Russian Academy
of Sciences, 630090Novosibirsk, Russia,
| |
Collapse
|
19
|
Lee PM, Chen HY, Gordon JW, Wang ZJ, Bok R, Hashoian R, Kim Y, Liu X, Nickles T, Cheung K, De Las Alas F, Daniel H, Larson PEZ, von Morze C, Vigneron DB, Ohliger MA. Whole-Abdomen Metabolic Imaging of Healthy Volunteers Using Hyperpolarized [1- 13 C]pyruvate MRI. J Magn Reson Imaging 2022; 56:1792-1806. [PMID: 35420227 PMCID: PMC9562149 DOI: 10.1002/jmri.28196] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Hyperpolarized 13 C MRI quantitatively measures enzyme-catalyzed metabolism in cancer and metabolic diseases. Whole-abdomen imaging will permit dynamic metabolic imaging of several abdominal organs simultaneously in healthy and diseased subjects. PURPOSE Image hyperpolarized [1-13 C]pyruvate and products in the abdomens of healthy volunteers, overcoming challenges of motion, magnetic field variations, and spatial coverage. Compare hyperpolarized [1-13 C]pyruvate metabolism across abdominal organs of healthy volunteers. STUDY TYPE Prospective technical development. SUBJECTS A total of 13 healthy volunteers (8 male), 21-64 years (median 36). FIELD STRENGTH/SEQUENCE A 3 T. Proton: T1 -weighted spoiled gradient echo, T2 -weighted single-shot fast spin echo, multiecho fat/water imaging. Carbon-13: echo-planar spectroscopic imaging, metabolite-specific echo-planar imaging. ASSESSMENT Transmit magnetic field was measured. Variations in main magnetic field (ΔB0 ) determined using multiecho proton acquisitions were compared to carbon-13 acquisitions. Changes in ΔB0 were measured after localized shimming. Improvements in metabolite signal-to-noise ratio were calculated. Whole-organ regions of interests were drawn over the liver, spleen, pancreas, and kidneys by a single investigator. Metabolite signals, time-to-peak, decay times, and mean first-order rate constants for pyruvate-to-lactate (kPL ) and alanine (kPA ) conversion were measured in each organ. STATISTICAL TESTS Linear regression, one-sample Kolmogorov-Smirnov tests, paired t-tests, one-way ANOVA, Tukey's multiple comparisons tests. P ≤ 0.05 considered statistically significant. RESULTS Proton ΔB0 maps correlated with carbon-13 ΔB0 maps (slope = 0.93, y-intercept = -2.88, R2 = 0.73). Localized shimming resulted in mean frequency offset within ±25 Hz for all organs. Metabolite SNR significantly increased after denoising. Mean kPL and kPA were highest in liver, followed by pancreas, spleen, and kidneys (all comparisons with liver were significant). DATA CONCLUSION Whole-abdomen coverage with hyperpolarized carbon-13 MRI was feasible despite technical challenges. Multiecho gradient echo 1 H acquisitions accurately predicted chemical shifts observed using carbon-13 spectroscopy. Carbon-13 acquisitions benefited from local shimming. Metabolite energetics in the abdomen compiled for healthy volunteers can be used to design larger clinical trials in patients with metabolic diseases. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
Collapse
Affiliation(s)
- Philip M Lee
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | | | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Tanner Nickles
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Kiersten Cheung
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Francesca De Las Alas
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Heather Daniel
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Peder EZ Larson
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Cornelius von Morze
- Mallinckrodt Institute of Radiology, Washington University in St. Louis; St. Louis, Missouri, USA
| | - Daniel B Vigneron
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Michael A Ohliger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology, Zuckerberg San Francisco General Hospital and Trauma Center; San Francisco, California, USA
| |
Collapse
|
20
|
Agudelo JP, Upadhyay D, Zhang D, Zhao H, Nolley R, Sun J, Agarwal S, Bok RA, Vigneron DB, Brooks JD, Kurhanewicz J, Peehl DM, Sriram R. Multiparametric Magnetic Resonance Imaging and Metabolic Characterization of Patient-Derived Xenograft Models of Clear Cell Renal Cell Carcinoma. Metabolites 2022; 12:1117. [PMID: 36422257 PMCID: PMC9692472 DOI: 10.3390/metabo12111117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 08/26/2023] Open
Abstract
Patient-derived xenografts (PDX) are high-fidelity cancer models typically credentialled by genomics, transcriptomics and proteomics. Characterization of metabolic reprogramming, a hallmark of cancer, is less frequent. Dysregulated metabolism is a key feature of clear cell renal cell carcinoma (ccRCC) and authentic preclinical models are needed to evaluate novel imaging and therapeutic approaches targeting metabolism. We characterized 5 PDX from high-grade or metastatic ccRCC by multiparametric magnetic resonance imaging (MRI) and steady state metabolic profiling and flux analysis. Similar to MRI of clinical ccRCC, T2-weighted images of orthotopic tumors of most PDX were homogeneous. The increased hyperintense (cystic) areas observed in one PDX mimicked the cystic phenotype typical of some RCC. The negligible hypointense (necrotic) areas of PDX grown under the highly vascularized renal capsule are beneficial for preclinical studies. Mean apparent diffusion coefficient (ADC) values were equivalent to those of ccRCC in human patients. Hyperpolarized (HP) [1-13C]pyruvate MRI of PDX showed high glycolytic activity typical of high-grade primary and metastatic ccRCC with considerable intra- and inter-tumoral variability, as has been observed in clinical HP MRI of ccRCC. Comparison of steady state metabolite concentrations and metabolic flux in [U-13C]glucose-labeled tumors highlighted the distinctive phenotypes of two PDX with elevated levels of numerous metabolites and increased fractional enrichment of lactate and/or glutamate, capturing the metabolic heterogeneity of glycolysis and the TCA cycle in clinical ccRCC. Culturing PDX cells and reimplanting to generate xenografts (XEN), or passaging PDX in vivo, altered some imaging and metabolic characteristics while transcription remained like that of the original PDX. These findings show that PDX are realistic models of ccRCC for imaging and metabolic studies but that the plasticity of metabolism must be considered when manipulating PDX for preclinical studies.
Collapse
Affiliation(s)
- Joao Piraquive Agudelo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Deepti Upadhyay
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Dalin Zhang
- Department of Urology, Stanford University, Stanford, CA 94305, USA
| | - Hongjuan Zhao
- Department of Urology, Stanford University, Stanford, CA 94305, USA
| | - Rosalie Nolley
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Jinny Sun
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Shubhangi Agarwal
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Robert A. Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - James D. Brooks
- Department of Urology, Stanford University, Stanford, CA 94305, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Donna M. Peehl
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| |
Collapse
|
21
|
Hu JY, Kim Y, Autry AW, Frost MM, Bok RA, Villanueva-Meyer JE, Xu D, Li Y, Larson PEZ, Vigneron DB, Gordon JW. Kinetic analysis of multi-resolution hyperpolarized 13 C human brain MRI to study cerebral metabolism. Magn Reson Med 2022; 88:2190-2197. [PMID: 35754148 PMCID: PMC9420752 DOI: 10.1002/mrm.29354] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE To investigate multi-resolution hyperpolarized (HP) 13 C pyruvate MRI for measuring kinetic conversion rates in the human brain. METHODS HP [1-13 C]pyruvate MRI was acquired in 6 subjects with a multi-resolution EPI sequence at 7.5 × 7.5 mm2 resolution for pyruvate and 15 × 15 mm2 resolution for lactate and bicarbonate. With the same lactate data, 2 quantitative maps of pyruvate-to-lactate conversion (kPL ) maps were generated: 1 using 7.5 × 7.5 mm2 resolution pyruvate data and the other using synthetic 15 × 15 mm2 resolution pyruvate data to simulate a standard constant resolution acquisition. To examine local kPL values, 4 voxels were manually selected in each study representing brain tissue near arteries, brain tissue near veins, white matter, and gray matter. RESULTS High resolution 7.5 × 7.5 mm2 pyruvate images increased the spatial delineation of brain structures and decreased partial volume effects compared to coarser resolution 15 × 15 mm2 pyruvate images. Voxels near arteries, veins and in white matter exhibited higher calculated kPL for multi-resolution images. CONCLUSION Acquiring HP 13 C pyruvate metabolic data with a multi-resolution approach minimized partial volume effects from vascular pyruvate signals while maintaining the SNR of downstream metabolites. Higher resolution pyruvate images for kinetic fitting resulted in increased kinetic rate values, particularly around the superior sagittal sinus and cerebral arteries, by reducing extracellular pyruvate signal contributions from adjacent blood vessels. This HP 13 C study showed that acquiring pyruvate with finer resolution improved the quantification of kinetic rates throughout the human brain.
Collapse
Affiliation(s)
- Jasmine Y Hu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Mary M Frost
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
22
|
Liu X, Tang S, Mu C, Qin H, Cu D, Lai YC, Riselli AM, Delos Santos R, Carvajal L, Gebrezgiabhier D, Bok RA, Chen HY, Flavell RR, Gordon JW, Vigneron DB, Kurhanewicz J, Larson PE. Development of specialized magnetic resonance acquisition techniques for human hyperpolarized [ 13 C, 15 N 2 ]urea + [1- 13 C]pyruvate simultaneous perfusion and metabolic imaging. Magn Reson Med 2022; 88:1039-1054. [PMID: 35526263 PMCID: PMC9810116 DOI: 10.1002/mrm.29266] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE This study aimed to develop and demonstrate the in vivo feasibility of a 3D stack-of-spiral balanced steady-state free precession(3D-bSSFP) urea sequence, interleaved with a metabolite-specific gradient echo (GRE) sequence for pyruvate and metabolic products, for improving the SNR and spatial resolution of the first hyperpolarized 13 C-MRI human study with injection of co-hyperpolarized [1-13 C]pyruvate and [13 C,15 N2 ]urea. METHODS A metabolite-specific bSSFP urea imaging sequence was designed using a urea-specific excitation pulse, optimized TR, and 3D stack-of-spiral readouts. Simulations and phantom studies were performed to validate the spectral response of the sequence. The image quality of urea data acquired by the 3D-bSSFP sequence and the 2D-GRE sequence was evaluated with 2 identical injections of co-hyperpolarized [1-13 C]pyruvate and [13 C,15 N2 ]urea formula in a rat. Subsequently, the feasibility of the acquisition strategy was validated in a prostate cancer patient. RESULTS Simulations and phantom studies demonstrated that 3D-bSSFP sequence achieved urea-only excitation, while minimally perturbing other metabolites (<1%). An animal study demonstrated that compared to GRE, bSSFP sequence provided an ∼2.5-fold improvement in SNR without perturbing urea or pyruvate kinetics, and bSSFP approach with a shorter spiral readout reduced blurring artifacts caused by J-coupling of [13 C,15 N2 ]urea. The human study demonstrated the in vivo feasibility and data quality of the acquisition strategy. CONCLUSION The 3D-bSSFP urea sequence with a stack-of-spiral acquisition demonstrated significantly increased SNR and image quality for [13 C,15 N2 ]urea in co-hyperpolarized [1-13 C]pyruvate and [13 C,15 N2 ]urea imaging studies. This work lays the foundation for future human studies to achieve high-quality and high-SNR metabolism and perfusion images.
Collapse
Affiliation(s)
- Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Shuyu Tang
- HeartVista Inc., Los Altos, California, USA
| | - Changhua Mu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Hecong Qin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Di Cu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Ying-Chieh Lai
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
| | - Andrew M. Riselli
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Lucas Carvajal
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Daniel Gebrezgiabhier
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Robert A. Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Robert R. Flavell
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - Peder E.Z. Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| |
Collapse
|
23
|
Lau D, Corrie PG, Gallagher FA. MRI techniques for immunotherapy monitoring. J Immunother Cancer 2022; 10:e004708. [PMID: 36122963 PMCID: PMC9486399 DOI: 10.1136/jitc-2022-004708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 11/24/2022] Open
Abstract
MRI is a widely available clinical tool for cancer diagnosis and treatment monitoring. MRI provides excellent soft tissue imaging, using a wide range of contrast mechanisms, and can non-invasively detect tissue metabolites. These approaches can be used to distinguish cancer from normal tissues, to stratify tumor aggressiveness, and to identify changes within both the tumor and its microenvironment in response to therapy. In this review, the role of MRI in immunotherapy monitoring will be discussed and how it could be utilized in the future to address some of the unique clinical questions that arise from immunotherapy. For example, MRI could play a role in identifying pseudoprogression, mixed response, T cell infiltration, cell tracking, and some of the characteristic immune-related adverse events associated with these agents. The factors to be considered when developing MRI imaging biomarkers for immunotherapy will be reviewed. Finally, the advantages and limitations of each approach will be discussed, as well as the challenges for future clinical translation into routine clinical care. Given the increasing use of immunotherapy in a wide range of cancers and the ability of MRI to detect the microstructural and functional changes associated with successful response to immunotherapy, the technique has great potential for more widespread and routine use in the future for these applications.
Collapse
Affiliation(s)
- Doreen Lau
- Centre for Immuno-Oncology, University of Oxford, Oxford, UK
| | - Pippa G Corrie
- Department of Oncology, Addenbrooke's Hospital, Cambridge, UK
| | | |
Collapse
|
24
|
Yang M, Mahanty A, Jin C, Wong ANN, Yoo JS. Label-free metabolic imaging for sensitive and robust monitoring of anti-CD47 immunotherapy response in triple-negative breast cancer. J Immunother Cancer 2022; 10:jitc-2022-005199. [PMID: 36096527 PMCID: PMC9472253 DOI: 10.1136/jitc-2022-005199] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Immunotherapy is revolutionizing cancer treatment from conventional radiotherapies and chemotherapies to immune checkpoint inhibitors which use patients’ immune system to recognize and attack cancer cells. Despite the huge clinical success and vigorous development of immunotherapies, there is a significant unmet need for a robust tool to identify responders to specific immunotherapy. Early and accurate monitoring of immunotherapy response is indispensable for personalized treatment and effective drug development. Methods We established a label-free metabolic intravital imaging (LMII) technique to detect two-photon excited autofluorescence signals from two coenzymes, NAD(P)H (reduced nicotinamide adenine dinucleotide (phosphate) hydrogen) and FAD (flavin adenine dinucleotide) as robust imaging markers to monitor metabolic responses to immunotherapy. Murine models of triple-negative breast cancer (TNBC) were established and tested with different therapeutic regimens including anti-cluster of differentiation 47 (CD47) immunotherapy to monitor time-course treatment responses using the developed metabolic imaging technique. Results We first imaged the mechanisms of the CD47-signal regulatory protein alpha pathway in vivo, which unravels macrophage-mediated antibody-dependent cellular phagocytosis and illustrates the metabolism of TNBC cells and macrophages. We further visualized the autofluorescence of NAD(P)H and FAD and found a significant increase during tumor growth. Following anti-CD47 immunotherapy, the imaging signal was dramatically decreased demonstrating the sensitive monitoring capability of NAD(P)H and FAD imaging for therapeutic response. NAD(P)H and FAD intravital imaging also showed a marked decrease after chemotherapy and radiotherapy. A comparative study with conventional whole-body bioluminescence and fluorescent glucose imaging demonstrated superior sensitivity of metabolic imaging. Flow cytometry validated metabolic imaging results. In vivo immunofluorescent staining revealed the targeting ability of NAD(P)H imaging mainly for tumor cells and a small portion of immune-active cells and that of FAD imaging mainly for immunosuppressive cells such as M2-like tumor-associated macrophages. Conclusions Collectively, this study showcases the potential of the LMII technique as a powerful tool to visualize dynamic changes of heterogeneous cell metabolism of cancer cells and immune infiltrates in response to immunotherapy thus providing sensitive and complete monitoring. Leveraged on ability to differentiate cancer cells and immunosuppressive macrophages, the presented imaging approach provides particularly useful imaging biomarkers for emerged innate immune checkpoint inhibitors such as anti-CD47 therapy.
Collapse
Affiliation(s)
- Minfeng Yang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Arpan Mahanty
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Chunjing Jin
- The Affiliated Chuzhou Hospital of Anhui Medical University, The First People's Hospital of Chuzhou, Chuzhou, China
| | - Alex Ngai Nick Wong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jung Sun Yoo
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| |
Collapse
|
25
|
Initial Experience on Hyperpolarized [1-13C]Pyruvate MRI Multicenter Reproducibility—Are Multicenter Trials Feasible? Tomography 2022; 8:585-595. [PMID: 35314625 PMCID: PMC8938827 DOI: 10.3390/tomography8020048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/31/2022] Open
Abstract
Background: Magnetic resonance imaging (MRI) with hyperpolarized [1-13C]pyruvate allows real-time and pathway specific clinical detection of otherwise unimageable in vivo metabolism. However, the comparability between sites and protocols is unknown. Here, we provide initial experiences on the agreement of hyperpolarized MRI between sites and protocols by repeated imaging of same healthy volunteers in Europe and the US. Methods: Three healthy volunteers traveled for repeated multicenter brain MRI exams with hyperpolarized [1-13C]pyruvate within one year. First, multisite agreement was assessed with the same echo-planar imaging protocol at both sites. Then, this was compared to a variable resolution echo-planar imaging protocol. In total, 12 examinations were performed. Common metrics of 13C-pyruvate to 13C-lactate conversion were calculated, including the kPL, a model-based kinetic rate constant, and its model-free equivalents. Repeatability was evaluated with intraclass correlation coefficients (ICC) for absolute agreement computed using two-way random effects models. Results: The mean kPL across all examinations in the multisite comparison was 0.024 ± 0.0016 s−1. The ICC of the kPL was 0.83 (p = 0.14) between sites and 0.7 (p = 0.09) between examinations of the same volunteer at any of the two sites. For the model-free metrics, the lactate Z-score had similar site-to-site ICC, while it was considerably lower for the lactate-to-pyruvate ratio. Conclusions: Estimation of metabolic conversion from hyperpolarized [1-13C]pyruvate to lactate using model-based metrics such as kPL suggests close agreement between sites and examinations in volunteers. Our initial results support harmonization of protocols, support multicenter studies, and inform their design.
Collapse
|
26
|
Sushentsev N, McLean MA, Warren AY, Benjamin AJV, Brodie C, Frary A, Gill AB, Jones J, Kaggie JD, Lamb BW, Locke MJ, Miller JL, Mills IG, Priest AN, Robb FJL, Shah N, Schulte RF, Graves MJ, Gnanapragasam VJ, Brindle KM, Barrett T, Gallagher FA. Hyperpolarised 13C-MRI identifies the emergence of a glycolytic cell population within intermediate-risk human prostate cancer. Nat Commun 2022; 13:466. [PMID: 35075123 PMCID: PMC8786834 DOI: 10.1038/s41467-022-28069-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/02/2021] [Indexed: 02/08/2023] Open
Abstract
Hyperpolarised magnetic resonance imaging (HP 13C-MRI) is an emerging clinical technique to detect [1-13C]lactate production in prostate cancer (PCa) following intravenous injection of hyperpolarised [1-13C]pyruvate. Here we differentiate clinically significant PCa from indolent disease in a low/intermediate-risk population by correlating [1-13C]lactate labelling on MRI with the percentage of Gleason pattern 4 (%GP4) disease. Using immunohistochemistry and spatial transcriptomics, we show that HP 13C-MRI predominantly measures metabolism in the epithelial compartment of the tumour, rather than the stroma. MRI-derived tumour [1-13C]lactate labelling correlated with epithelial mRNA expression of the enzyme lactate dehydrogenase (LDHA and LDHB combined), and the ratio of lactate transporter expression between the epithelial and stromal compartments (epithelium-to-stroma MCT4). We observe similar changes in MCT4, LDHA, and LDHB between tumours with primary Gleason patterns 3 and 4 in an independent TCGA cohort. Therefore, HP 13C-MRI can metabolically phenotype clinically significant disease based on underlying metabolic differences in the epithelial and stromal tumour compartments.
Collapse
Affiliation(s)
- Nikita Sushentsev
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Anne Y Warren
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Arnold J V Benjamin
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Cara Brodie
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Amy Frary
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Andrew B Gill
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Julia Jones
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Joshua D Kaggie
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Benjamin W Lamb
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- School of Allied Health, Anglia Ruskin University, Cambridge, UK
| | - Matthew J Locke
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Jodi L Miller
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Ian G Mills
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
- Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Andrew N Priest
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | | | - Nimish Shah
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Martin J Graves
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Vincent J Gnanapragasam
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Division of Urology, Department of Surgery, University of Cambridge, Cambridge, UK
- Cambridge Urology Translational Research and Clinical Trials Office, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge, UK
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
| | - Ferdia A Gallagher
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| |
Collapse
|
27
|
Ursprung S, Woitek R, McLean MA, Priest AN, Crispin-Ortuzar M, Brodie CR, Gill AB, Gehrung M, Beer L, Riddick ACP, Field-Rayner J, Grist JT, Deen SS, Riemer F, Kaggie JD, Zaccagna F, Duarte JAG, Locke MJ, Frary A, Aho TF, Armitage JN, Casey R, Mendichovszky IA, Welsh SJ, Barrett T, Graves MJ, Eisen T, Mitchell TJ, Warren AY, Brindle KM, Sala E, Stewart GD, Gallagher FA. Hyperpolarized 13C-Pyruvate Metabolism as a Surrogate for Tumor Grade and Poor Outcome in Renal Cell Carcinoma-A Proof of Principle Study. Cancers (Basel) 2022; 14:335. [PMID: 35053497 PMCID: PMC8773685 DOI: 10.3390/cancers14020335] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
Differentiating aggressive clear cell renal cell carcinoma (ccRCC) from indolent lesions is challenging using conventional imaging. This work prospectively compared the metabolic imaging phenotype of renal tumors using carbon-13 MRI following injection of hyperpolarized [1-13C]pyruvate (HP-13C-MRI) and validated these findings with histopathology. Nine patients with treatment-naïve renal tumors (6 ccRCCs, 1 liposarcoma, 1 pheochromocytoma, 1 oncocytoma) underwent pre-operative HP-13C-MRI and conventional proton (1H) MRI. Multi-regional tissue samples were collected using patient-specific 3D-printed tumor molds for spatial registration between imaging and molecular analysis. The apparent exchange rate constant (kPL) between 13C-pyruvate and 13C-lactate was calculated. Immunohistochemistry for the pyruvate transporter (MCT1) from 44 multi-regional samples, as well as associations between MCT1 expression and outcome in the TCGA-KIRC dataset, were investigated. Increasing kPL in ccRCC was correlated with increasing overall tumor grade (ρ = 0.92, p = 0.009) and MCT1 expression (r = 0.89, p = 0.016), with similar results acquired from the multi-regional analysis. Conventional 1H-MRI parameters did not discriminate tumor grades. The correlation between MCT1 and ccRCC grade was confirmed within a TCGA dataset (p < 0.001), where MCT1 expression was a predictor of overall and disease-free survival. In conclusion, metabolic imaging using HP-13C-MRI differentiates tumor aggressiveness in ccRCC and correlates with the expression of MCT1, a predictor of survival. HP-13C-MRI may non-invasively characterize metabolic phenotypes within renal cancer.
Collapse
Affiliation(s)
- Stephan Ursprung
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Ramona Woitek
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Mary A. McLean
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Andrew N. Priest
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Mireia Crispin-Ortuzar
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Cara R. Brodie
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Andrew B. Gill
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Marcel Gehrung
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Lucian Beer
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Antony C. P. Riddick
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - Johanna Field-Rayner
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - James T. Grist
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Surrin S. Deen
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Frank Riemer
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Joshua D. Kaggie
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Fulvio Zaccagna
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Joao A. G. Duarte
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Matthew J. Locke
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Amy Frary
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Tevita F. Aho
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - James N. Armitage
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
| | - Ruth Casey
- Department of Endocrinology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Iosif A. Mendichovszky
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Sarah J. Welsh
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Oncology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Tristan Barrett
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Martin J. Graves
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
| | - Tim Eisen
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Oncology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Thomas J. Mitchell
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
- Wellcome Sanger Institute, Hinxton CB10 1RQ, UK
| | - Anne Y. Warren
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Pathology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Kevin M. Brindle
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
| | - Evis Sala
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| | - Grant D. Stewart
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (A.C.P.R.); (T.F.A.); (J.N.A.)
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Ferdia A. Gallagher
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0QQ, UK; (S.U.); (R.W.); (M.A.M.); (M.C.-O.); (C.R.B.); (A.B.G.); (M.G.); (L.B.); (J.F.-R.); (S.S.D.); (F.R.); (J.D.K.); (F.Z.); (J.A.G.D.); (M.J.L.); (A.F.); (I.A.M.); (S.J.W.); (T.B.); (T.E.); (T.J.M.); (A.Y.W.); (K.M.B.); (E.S.); (G.D.S.)
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; (A.N.P.); (J.T.G.)
| |
Collapse
|
28
|
Jørgensen SH, Bøgh N, Hansen E, Væggemose M, Wiggers H, Laustsen C. Hyperpolarized MRI - An update and future perspectives. Semin Nucl Med 2021; 52:374-381. [PMID: 34785033 DOI: 10.1053/j.semnuclmed.2021.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 11/11/2022]
Abstract
In recent years, hyperpolarized 13C magnetic resonance spectroscopic (MRS) imaging has emerged as a complementary metabolic imaging approach. Hyperpolarization via dissolution dynamic nuclear polarization is a technique that enhances the MR signal of 13C-enriched molecules by a factor of > 104, enabling detection downstream metabolites in a variety of intracellular metabolic pathways. The aim of the present review is to provide the reader with an update on hyperpolarized 13C MRS imaging and to assess the future clinical potential of the technology. Several carbon-based probes have been used in hyperpolarized studies. However, the first and most widely used 13C-probe in clinical studies is [1-13C]pyruvate. In this probe, the enrichment of 13C is performed at the first carbon position as the only modification. Hyperpolarized [1-13C]pyruvate MRS imaging can detect intracellular production of [1-13C]lactate and 13C-bicarbonate non-invasively and in real time without the use of ionizing radiation. Thus, by probing the balance between oxidative and glycolytic metabolism, hyperpolarized [1-13C]pyruvate MRS imaging can image the Warburg effect in malignant tumors and detect the hallmarks of ischemia or viability in the myocardium. An increasing number of clinical studies have demonstrated that clinical hyperpolarized 13C MRS imaging is not only possible, but also it provides metabolic information that was previously inaccessible by non-invasive techniques. Although the technology is still in its infancy and several technical improvements are warranted, it is of paramount importance that nuclear medicine physicians gain knowledge of the possibilities and pitfalls of the technique. Hyperpolarized 13C MRS imaging may become an integrated feature in combined metabolic imaging of the future.
Collapse
Affiliation(s)
- S H Jørgensen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; The Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark; The Department of Cardiology, North Denmark Regional Hospital, Hjørring, Denmark
| | - N Bøgh
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ess Hansen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - M Væggemose
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; GE Healthcare, Brøndby, Denmark
| | - H Wiggers
- The Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
| | - C Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| |
Collapse
|
29
|
Qin H, Tang S, Riselli AM, Bok RA, Delos Santos R, van Criekinge M, Gordon JW, Aggarwal R, Chen R, Goddard G, Zhang CT, Chen A, Reed G, Ruscitto DM, Slater J, Sriram R, Larson PEZ, Vigneron DB, Kurhanewicz J. Clinical translation of hyperpolarized 13 C pyruvate and urea MRI for simultaneous metabolic and perfusion imaging. Magn Reson Med 2021; 87:138-149. [PMID: 34374471 PMCID: PMC8616838 DOI: 10.1002/mrm.28965] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/30/2021] [Accepted: 07/23/2021] [Indexed: 11/11/2022]
Abstract
Purpose The combined hyperpolarized (HP) 13C pyruvate and urea MRI has provided a simultaneous assessment of glycolytic metabolism and tissue perfusion for improved cancer diagnosis and therapeutic evaluation in preclinical studies. This work aims to translate this dual‐probe HP imaging technique to clinical research. Methods A co‐polarization system was developed where [1‐13C]pyruvic acid (PA) and [13C, 15N2]urea in water solution were homogeneously mixed and polarized on a 5T SPINlab system. Physical and chemical characterizations and toxicology studies of the combined probe were performed. Simultaneous metabolic and perfusion imaging was performed on a 3T clinical MR scanner by alternatively applying a multi‐slice 2D spiral sequence for [1‐13C]pyruvate and its downstream metabolites and a 3D balanced steady‐state free precession (bSSFP) sequence for [13C, 15N2]urea. Results The combined PA/urea probe has a glass‐formation ability similar to neat PA and can generate nearly 40% liquid‐state 13C polarization for both pyruvate and urea in 3‐4 h. A standard operating procedure for routine on‐site production was developed and validated to produce 40 mL injection product of approximately 150 mM pyruvate and 35 mM urea. The toxicology study demonstrated the safety profile of the combined probe. Dynamic metabolite‐specific imaging of [1‐13C]pyruvate, [1‐13C]lactate, [1‐13C]alanine, and [13C, 15N2]urea was achieved with adequate spatial (2.6 mm × 2.6 mm) and temporal resolution (4.2 s), and urea images showed reduced off‐resonance artifacts due to the JCN coupling. Conclusion The reported technical development and translational studies will lead to the first‐in‐human dual‐agent HP MRI study and mark the clinical translation of the first HP 13C MRI probe after pyruvate.
Collapse
Affiliation(s)
- Hecong Qin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Andrew M Riselli
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Mark van Criekinge
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Rahul Aggarwal
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Rui Chen
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | | | | | - Albert Chen
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | - Galen Reed
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | | | - James Slater
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| |
Collapse
|