Advanced Hyperpolarized 13C Metabolic Imaging Protocol for Patients with Gliomas: A Comprehensive Multimodal MRI Approach

• Published in: Cancers 2024-01, Vol.16 (2), p.354
• Main Authors: Autry, Adam W., Vaziri, Sana, Gordon, Jeremy W., Chen, Hsin-Yu, Kim, Yaewon, Dang, Duy, LaFontaine, Marisa, Noeske, Ralph, Bok, Robert, Villanueva-Meyer, Javier E., Clarke, Jennifer L., Oberheim Bush, Nancy Ann, Chang, Susan M., Xu, Duan, Lupo, Janine M., Larson, Peder E. Z., Vigneron, Daniel B., Li, Yan
• Format: Article
• Language: English
• Subjects: Brain cancer; Brain tumors; Carbon 13; Glioma; Glycolysis; Magnetic resonance imaging; Metabolism; Metabolites; Neuroimaging; Oxidative phosphorylation; Patients; Phosphorylation; Power; Pyruvic acid; Scanners
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16020354

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.