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Imaging Glioblastoma Metabolism by Using Hyperpolarized [1-(13)C]Pyruvate Demonstrates Heterogeneity in Lactate Labeling: A Proof of Principle Study

PURPOSE: To evaluate glioblastoma (GBM) metabolism by using hyperpolarized carbon 13 ((13)C) MRI to monitor the exchange of the hyperpolarized (13)C label between injected [1-(13)C]pyruvate and tumor lactate and bicarbonate. MATERIALS AND METHODS: In this prospective study, seven treatment-naive pat...

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Detalles Bibliográficos
Autores principales: Zaccagna, Fulvio, McLean, Mary A., Grist, James T., Kaggie, Joshua, Mair, Richard, Riemer, Frank, Woitek, Ramona, Gill, Andrew B., Deen, Surrin, Daniels, Charlie J., Ursprung, Stephan, Schulte, Rolf F., Allinson, Kieren, Chhabra, Anita, Laurent, Marie-Christine, Locke, Matthew, Frary, Amy, Hilborne, Sarah, Patterson, Ilse, Carmo, Bruno D., Slough, Rhys, Wilkinson, Ian, Basu, Bristi, Wason, James, Gillard, Jonathan H., Matys, Tomasz, Watts, Colin, Price, Stephen J., Santarius, Thomas, Graves, Martin J., Jefferies, Sarah, Brindle, Kevin M., Gallagher, Ferdia A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Radiological Society of North America 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360994/
https://www.ncbi.nlm.nih.gov/pubmed/35838532
http://dx.doi.org/10.1148/rycan.210076
Descripción
Sumario:PURPOSE: To evaluate glioblastoma (GBM) metabolism by using hyperpolarized carbon 13 ((13)C) MRI to monitor the exchange of the hyperpolarized (13)C label between injected [1-(13)C]pyruvate and tumor lactate and bicarbonate. MATERIALS AND METHODS: In this prospective study, seven treatment-naive patients (age [mean ± SD], 60 years ± 11; five men) with GBM were imaged at 3 T by using a dual-tuned (13)C–hydrogen 1 head coil. Hyperpolarized [1-(13)C]pyruvate was injected, and signal was acquired by using a dynamic MRI spiral sequence. Metabolism was assessed within the tumor, in the normal-appearing brain parenchyma (NABP), and in healthy volunteers by using paired or unpaired t tests and a Wilcoxon signed rank test. The Spearman ρ correlation coefficient was used to correlate metabolite labeling with lactate dehydrogenase A (LDH-A) expression and some immunohistochemical markers. The Benjamini-Hochberg procedure was used to correct for multiple comparisons. RESULTS: The bicarbonate-to-pyruvate (BP) ratio was lower in the tumor than in the contralateral NABP (P < .01). The tumor lactate-to-pyruvate (LP) ratio was not different from that in the NABP (P = .38). The LP and BP ratios in the NABP were higher than those observed previously in healthy volunteers (P < .05). Tumor lactate and bicarbonate signal intensities were strongly correlated with the pyruvate signal intensity (ρ = 0.92, P < .001, and ρ = 0.66, P < .001, respectively), and the LP ratio was weakly correlated with LDH-A expression in biopsy samples (ρ = 0.43, P = .04). CONCLUSION: Hyperpolarized (13)C MRI demonstrated variation in lactate labeling in GBM, both within and between tumors. In contrast, bicarbonate labeling was consistently lower in tumors than in the surrounding NABP. Keywords: Hyperpolarized (13)C MRI, Glioblastoma, Metabolism, Cancer, MRI, Neuro-oncology Supplemental material is available for this article. Published under a CC BY 4.0 license.