Zaccagna Fulvio, Grist James T, Deen Surrin S, Woitek Ramona, Lechermann Laura Mt, McLean Mary A, Basu Bristi, Gallagher Ferdia A
1 Department of Radiology, University of Cambridge , Cambridge , UK.
2 Cancer Research UK Cambridge Institute, University of Cambridge , Cambridge , UK.
Br J Radiol. 2018 May;91(1085):20170688. doi: 10.1259/bjr.20170688. Epub 2018 Jan 19.
Glucose metabolism in tumours is reprogrammed away from oxidative metabolism, even in the presence of oxygen. Non-invasive imaging techniques can probe these alterations in cancer metabolism providing tools to detect tumours and their response to therapy. Although Positron Emission Tomography with (F)2-fluoro-2-deoxy-D-glucose (F-FDG PET) is an established clinical tool to probe cancer metabolism, it has poor spatial resolution and soft tissue contrast, utilizes ionizing radiation and only probes glucose uptake and phosphorylation and not further downstream metabolism. Magnetic Resonance Spectroscopy (MRS) has the capability to non-invasively detect and distinguish molecules within tissue but has low sensitivity and can only detect selected nuclei. Dynamic Nuclear Polarization (DNP) is a technique which greatly increases the signal-to-noise ratio (SNR) achieved with MR by significantly increasing nuclear spin polarization and this method has now been translated into human imaging. This review provides a brief overview of this process, also termed Hyperpolarized Carbon-13 Magnetic Resonance Spectroscopic Imaging (HP C-MRSI), its applications in preclinical imaging, an outline of the current human trials that are ongoing, as well as future potential applications in oncology.
肿瘤中的葡萄糖代谢会从氧化代谢重新编程，即使在有氧的情况下也是如此。非侵入性成像技术可以探测癌症代谢中的这些改变，为检测肿瘤及其对治疗的反应提供工具。尽管正电子发射断层扫描（PET）结合（F）2-氟-2-脱氧-D-葡萄糖（F-FDG PET）是探测癌症代谢的一种成熟临床工具，但它的空间分辨率和软组织对比度较差，使用电离辐射，并且只探测葡萄糖摄取和磷酸化，而不探测进一步的下游代谢。磁共振波谱（MRS）有能力非侵入性地检测和区分组织内的分子，但灵敏度较低，只能检测选定的原子核。动态核极化（DNP）是一种通过显著增加核自旋极化来极大提高磁共振信噪比（SNR）的技术，这种方法现已转化为人体成像。本综述简要概述了这一过程，也称为超极化碳-13磁共振波谱成像（HP C-MRSI），其在临床前成像中的应用，当前正在进行的人体试验概述，以及未来在肿瘤学中的潜在应用。
