Purpose: Metabolic magnetic resonance imaging (MRI) using hyperpolarized [1-13 C]-pyruvate offers unprecedented new insight into disease and response to therapy. 13 C-enriched reference standards are required to enable fast and accurate calibration for 13 C studies, but care must be taken to ensure that the reference is compatible with both 13 C and 1 H acquisitions. The goal of this study was to optimize the composition of a 13 C-urea reference for a dual-tuned 13 C/ 1 H endorectal coil and minimize imaging artifacts in metabolic and multiparametric MRI studies involving hyperpolarized [1-13 C]-pyruvate. Methods: Due to a high amount of Gd doping for the purpose of reducing the spin-lattice relaxation time (T 1 ) of urea, the 1 H signal produced by a reference of 13 C-urea in normal water was rapidly relaxed, resulting in severe artifacts in heavily T 1 -weighted images. Hyperintense ringing artifacts in 1 H images were mitigated by reducing the 1 H concentration in a 13 C-urea reference via deuteration and lyophilization. Several references were fabricated and their SNR was compared using 1 H and 13 C imaging sequences on a 3T MRI scanner. Finally, 1 H prostate phantom imaging was conducted to compare image quality and 1 H signal intensity of normal and deuterated urea references. Results: The deuterated 13 C-urea reference provides strong 13 C signal for calibration and an attenuated 1 H signal that does not interfere with heavily T 1 -weighted scans. Deuteration and lyophilization were fundamental to the reduction in 1 H signal and hyperintense ringing artifacts. There was a 25fold reduction in signal intensity when comparing the nondeuterated reference to the deuterated reference, while the 13 C signal was unaffected. Conclusion: A deuterated reference reduced hyperintense ringing artifacts in 1 H images by reducing the 1 H signal produced from the 13 C-urea in the reference. The deuterated reference can be used to improve anatomical image quality in future clinical 1 H and hyperpolarized [1-13 C]-pyruvate MRI prostate imaging studies.

The extracellular tumor microenvironment of many solid tumors has high acidosis and high protease activity. Simultaneously assessing both characteristics may improve diagnostic evaluations of aggressive tumors and the effects of anticancer treatments. Noninvasive imaging methods have previously been developed that measure extracellular pH or can detect enzyme activity using chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI). Herein, we developed a single-hybrid CEST agent that can simultaneously measure pH and evaluate protease activity using a combination of dual-power acidoCEST MRI and catalyCEST MRI. Our agent showed CEST signals at 9.2 ppm from a salicylic acid moiety and at 5.0 ppm from an aryl amide. The CEST signal at 9.2 ppm could be measured after selective saturation was applied at 1 and 4 μT, and these measurements could be used with a ratiometric analysis to determine pH. The CEST signal at 5.0 ppm from the aryl amide disappeared after the agent was treated with cathepsin B, while the CEST signal at 9.2 ppm remained, indicating that the agent could detect protease activity through the amide bond cleavage. Michaelis–Menten kinetics studies with catalyCEST MRI demonstrated that the binding affinity (as shown with the Michaelis constant K M), the catalytic turnover rate (k cat), and catalytic efficiency (k cat/K M) were each higher for cathepsin B at lower pH. The k cat rates measured with catalyCEST MRI were lower than the comparable rates measured with liquid chromatography–mass spectrometry (LC–MS), which reflected a limitation of inherently noisy and relatively insensitive CEST MRI analyses. Although this level of precision limited catalyCEST MRI to semiquantitative evaluations, these semiquantitative assessments of high and low protease activity still had value by demonstrating that high acidosis and high protease activity can be used as synergistic, multiparametric biomarkers.

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