Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, 430071, China.
Eur Radiol Exp. 2024 Jun 3;8(1):65. doi: 10.1186/s41747-024-00464-y.
Deuterium metabolic imaging (DMI) has emerged as a promising non-invasive technique for studying metabolism in vivo. This review aims to summarize the current developments and discuss the futures in DMI technique in vivo.
A systematic literature review was conducted based on the PRISMA 2020 statement by two authors. Specific technical details and potential applications of DMI in vivo were summarized, including strategies of deuterated metabolites detection, deuterium-labeled tracers and corresponding metabolic pathways in vivo, potential clinical applications, routes of tracer administration, quantitative evaluations of metabolisms, and spatial resolution.
Of the 2,248 articles initially retrieved, 34 were finally included, highlighting 2 strategies for detecting deuterated metabolites: direct and indirect DMI. Various deuterated tracers (e.g., [6,6'-H2]glucose, [2,2,2'-H3]acetate) were utilized in DMI to detect and quantify different metabolic pathways such as glycolysis, tricarboxylic acid cycle, and fatty acid oxidation. The quantifications (e.g., lactate level, lactate/glutamine and glutamate ratio) hold promise for diagnosing malignancies and assessing early anti-tumor treatment responses. Tracers can be administered orally, intravenously, or intraperitoneally, either through bolus administration or continuous infusion. For metabolic quantification, both serial time point methods (including kinetic analysis and calculation of area under the curves) and single time point quantifications are viable. However, insufficient spatial resolution remains a major challenge in DMI (e.g., 3.3-mL spatial resolution with 10-min acquisition at 3 T).
Enhancing spatial resolution can facilitate the clinical translation of DMI. Furthermore, optimizing tracer synthesis, administration protocols, and quantification methodologies will further enhance their clinical applicability.
Deuterium metabolic imaging, a promising non-invasive technique, is systematically discussed in this review for its current progression, limitations, and future directions in studying in vivo energetic metabolism, displaying a relevant clinical potential.
• Deuterium metabolic imaging (DMI) shows promise for studying in vivo energetic metabolism. • This review explores DMI's current state, limits, and future research directions comprehensively. • The clinical translation of DMI is mainly impeded by limitations in spatial resolution.
氘代谢成像是一种有前途的非侵入性技术，可用于研究体内代谢。本综述旨在总结氘代谢成像技术的最新进展，并探讨其在体内的未来发展方向。
两位作者按照 PRISMA 2020 声明进行了系统的文献回顾。总结了氘代谢成像技术的具体技术细节和潜在应用，包括检测氘代代谢物的策略、体内氘标记示踪剂和相应的代谢途径、潜在的临床应用、示踪剂给药途径、代谢的定量评估以及空间分辨率。
最初检索到 2248 篇文章，最终纳入 34 篇，突出了两种检测氘代代谢物的策略：直接和间接的氘代谢成像。各种氘代示踪剂（如 [6,6'-H2]葡萄糖、[2,2,2'-H3]乙酸）被用于检测和定量不同的代谢途径，如糖酵解、三羧酸循环和脂肪酸氧化。定量（如乳酸水平、乳酸/谷氨酰胺和谷氨酸比值）有望用于诊断恶性肿瘤和评估早期抗肿瘤治疗反应。示踪剂可以口服、静脉内或腹腔内给药，通过推注或连续输注。对于代谢物的定量，无论是连续时间点法（包括动力学分析和曲线下面积的计算）还是单点时间定量都可行。然而，氘代谢成像的空间分辨率仍然是一个主要挑战（如 3T 下 10 分钟采集时的 3.3 毫升空间分辨率）。
提高空间分辨率可以促进氘代谢成像的临床转化。此外，优化示踪剂合成、给药方案和定量方法将进一步提高其临床适用性。
本综述系统地讨论了氘代谢成像技术，探讨了其在研究体内能量代谢方面的最新进展、局限性和未来方向，具有重要的临床潜力。
氘代谢成像（DMI）在研究体内能量代谢方面显示出应用前景。
本综述全面探讨了 DMI 的现状、局限性和未来研究方向。
DMI 的临床转化主要受到空间分辨率的限制。
