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- Title
Advanced Hyperpolarized 13 C Metabolic Imaging Protocol for Patients with Gliomas: A Comprehensive Multimodal MRI Approach.
- 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
- Abstract
Simple Summary: Dynamic hyperpolarized carbon-13 (HP-13C) MRI is a novel molecular imaging technique that allows for real-time in vivo imaging of glycolysis and oxidative phosphorylation using [1-13C]pyruvate as a non-radioactive and non-toxic metabolic probe. While HP-13C MRI has recently demonstrated the potential to capture Warburg-related metabolic dysregulation in patients with progressive/treatment-naïve high-grade gliomas, further improvement in methodologies is still necessary to help monitor disease status and evaluate early predictors of therapeutic response. To this end, a multimodal 1H/HP-13C MRI protocol was implemented in this study, which incorporated advanced brain tumor MR acquisitions and improved HP-13C metabolic imaging methodologies for the serial monitoring of patients with glioma over the course of clinical treatment. 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.
- Subjects
DATA quality; MOLECULAR diagnosis; GLIOMAS; MAGNETIC resonance imaging; MEDICAL protocols; DIAGNOSTIC imaging; PATIENT monitoring; DESCRIPTIVE statistics; RESEARCH funding
- Publication
Cancers, 2024, Vol 16, Issue 2, p354
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16020354