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.
Highlights
Magnetic Resonance (MR) spectroscopy (MRS) and spectroscopic imaging (MRSI) obtain metabolic information noninvasively from nuclei spins
Metabolic and functional HP 13C Magnetic Resonance Imaging (MRI) is a promising diagnostic tool for detecting disorders linked to altered metabolism such as cancer, diabetes, and heart diseases [4], increasing sensitivity sufficiently to map metabolic pathways in vivo without the use of ionizing radiation, as in positron emission tomography (PET) imaging
This review aims to address the current status of HP 13C MRI, based on the literature from the last two decades, and provide a comparison across multiple anatomical applications, highlighting the future directions needed to elevate the method for more widespread adoption in clinical practice
Summary
MR spectroscopy (MRS) and spectroscopic imaging (MRSI) obtain metabolic information noninvasively from nuclei spins. Common MR-active nuclei are protons (1H), phosphorus (31P), carbon (13C), sodium (23Na), and xenon (129Xe). The most common are protons due to their high gyromagnetic ratio and natural abundance in the human body. 13C spectra are characterized by a large spectral range (162–185 ppm), narrow line widths, and low sensitivity due to the low gyromagnetic ratio (a quarter as compared to protons) and natural abundance of 1.1% in vivo. Metabolic and functional HP 13C MRI is a promising diagnostic tool for detecting disorders linked to altered metabolism such as cancer, diabetes, and heart diseases [4], increasing sensitivity sufficiently to map metabolic pathways in vivo without the use of ionizing radiation, as in positron emission tomography (PET) imaging.
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