C-13 Hyperpolarized MR Spectroscopy for Metabolic Imaging of Brain Tumors

Abstract

Our understanding of the molecular basis of glioma initiation and maintenance has increased tremendously in recent years. This information needs to be incorporated into clinical patient management in order to make personalized neuro-oncology a reality. One promising approach is metabolic imaging, which can translate metabolic information that reflects the molecular features of glioma into noninvasive imaging biomarkers that can impact diagnosis, treatment selection, and monitoring of response to therapy. A novel metabolic imaging modality is hyperpolarized 13C-magnetic resonance spectroscopy (MRS) which can be used to noninvasively quantify metabolic fluxes in real time in vivo. The aim of this review is to provide an understanding of the current state of the art in glioma imaging using hyperpolarized 13C-MRS. We will review the various hyperpolarized 13C-MRS studies in preclinical glioma models as well as studies in brain tumor patients that highlight the promise and the challenges associated with translation of this technology to the clinic.