Quo Vadis Hyperpolarized 13C MRI?

Pascal Wodtke; Martin Grashei; Franz Schilling

doi:10.1016/j.zemedi.2023.10.004

Quo Vadis Hyperpolarized ¹³C MRI?

Z Med Phys. 2023 Dec 29:S0939-3889(23)00120-4. doi: 10.1016/j.zemedi.2023.10.004. Online ahead of print.

Authors

Pascal Wodtke¹, Martin Grashei², Franz Schilling³

Affiliations

¹ Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany; Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge UK.
² Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany.
³ Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany; Munich Institute of Biomedical Engineering, Technical University of Munich, 85748 Garching, Germany; German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany. Electronic address: schilling@tum.de.

PMID: 38160135
DOI: 10.1016/j.zemedi.2023.10.004

Abstract

Over the last two decades, hyperpolarized ¹³C MRI has gained significance in both preclinical and clinical studies, hereby relying on technologies like PHIP-SAH (ParaHydrogen-Induced Polarization-Side Arm Hydrogenation), SABRE (Signal Amplification by Reversible Exchange), and dDNP (dissolution Dynamic Nuclear Polarization), with dDNP being applied in humans. A clinical dDNP polarizer has enabled studies across 24 sites, despite challenges like high cost and slow polarization. Parahydrogen-based techniques like SABRE and PHIP offer faster, more cost-efficient alternatives but require molecule-specific optimization. The focus has been on imaging metabolism of hyperpolarized probes, which requires long T₁, high polarization and rapid contrast generation. Efforts to establish novel probes, improve acquisition techniques and enhance data analysis methods including artificial intelligence are ongoing. Potential clinical value of hyperpolarized ¹³C MRI was demonstrated primarily for treatment response assessment in oncology, but also in cardiology, nephrology, hepatology and CNS characterization. In this review on biomedical hyperpolarized ¹³C MRI, we summarize important and recent advances in polarization techniques, probe development, acquisition and analysis methods as well as clinical trials. Starting from those we try to sketch a trajectory where the field of biomedical hyperpolarized ¹³C MRI might go.

Keywords: DNP; Hyperpolarization; Hyperpolarized (13)C MRI; Magnetic Resonance Imaging; Molecular Imaging; PHIP; SABRE; carbon-13.

Publication types

Review