Comprehensive Literature Review of Hyperpolarized Carbon-13 MRI: The Road to Clinical Application

Abstract

This review provides a comprehensive assessment of the development of hyperpolarized (HP) carbon-13 metabolic MRI from the early days to the present with a focus on clinical applications. The status and upcoming challenges of translating HP carbon-13 into clinical application are reviewed, along with the complexity, technical advancements, and future directions. The road to clinical application is discussed regarding clinical needs and technological advancements, highlighting the most recent successes of metabolic imaging with hyperpolarized carbon-13 MRI. Given the current state of hyperpolarized carbon-13 MRI, the conclusion of this review is that the workflow for hyperpolarized carbon-13 MRI is the limiting factor.

Imaging Neurodegenerative Metabolism in Amyotrophic Lateral Sclerosis with Hyperpolarized [1-13C]pyruvate MRI

“…MRI with hyperpolarized [1-13 C]pyruvate is a technology under development. Since the initial clinical trial, an abundance of smaller trials has been published [3]. Now, larger single-center studies are ongoing, multisite trials are possible [28], and the technology is able to provide good quality data routinely.…”

“…The lactate and bicarbonate signals thus represent imaging readouts that are sensitive to blood-brain barrier uptake and subsequent glycolytic and oxidative metabolism. The technology is currently under clinical translation with a particulate focus on cancer imaging [3]. Here, we present an initial experience on its feasibility and potential in neurodegenerative disease.…”

“…According to its age and production process, the color of OMW varies from dark red to black. This dark colored wastewater with very large contents of organic matter, recalcitrant/toxic components such as significant concentration of phenolic compounds (polyphenols, tannins), sugars, proteins, and considerable salt concentration is a substantial pollutant and environmentally hazardous [2][3][4][5]. Given the lack of technologies capable of treating these wastewaters, due to their characteristics, the most common practice is to proceed with their disposal in ponds and the paste resulting from this process is discharged into soil.…”

Deuterium metabolic imaging and hyperpolarized13C-MRI of the normal human brain at clinical field strength reveals differential cerebral metabolism

“…However, the way in which these techniques differ in probing human brain metabolism has not been studied previously. One of the major challenges in undertaking a direct comparison between the two techniques in humans is that 13 C-HPMRI is usually undertaken at 3 T, which allows good spectral separation of metabolites while maintaining a sufficiently long relaxation time for the hyperpolarized signal to enable detection of both the injected hyperpolarized substrate and the subsequently formed metabolites (Vaeggemose et al, 2021). In comparison, DMI has been applied at field strengths of up to 16.4 T for improved spectral separation and signal-to-noise (Lu et al, 2017), with clinical DMI having previously been undertaken at field strengths of 4 T and higher, which are not used in routine clinical practice (De Feyter et al, 2018; de Graaf et al, 2020; Ruhm et al, 2021).…”

“…Deuterium ( 2 H) metabolic imaging (DMI) and hyperpolarized carbon-13 metabolic MRI ( 13 C-HPMRI) are emerging techniques to probe dynamic changes in tissue metabolism using MRI without the use of ionizing radiation (Ardenkjær-Larsen et al, 2003; De Feyter et al, 2018; Vaeggemose et al, 2021; Woitek and Gallagher, 2021; Zaccagna et al, 2018). Due to the distinct biological and nuclear properties of these isotopes of hydrogen and carbon, metabolic pathways can be differentially probed using the two techniques.…”