Hyperpolarized 13C MRI and PET: in vivo tumor biochemistry

Dynamic nuclear polarization (DNP) is an emerging technique for dramatically increasing the sensitivity of magnetic resonance spectroscopy (MRS). This review evaluates the potential strengths and weaknesses of DNP-enhanced (13)C magnetic resonance spectroscopic imaging (DNP-MRSI) as a clinical imaging technique in comparison to PET. The major advantage of MRS is chemical shift, which enables the injected molecule to be observed separately from its metabolites, whereas the major advantage of PET is its high sensitivity. Factors such as spatial and temporal resolution and potential risks and costs of the two techniques will be discussed. PET tracers and (13)C-labeled molecules that can be used in oncology will be reviewed with reference to the biologic processes they detect. Because DNP-MRSI and PET are, in principle, similar techniques for assessing tumor metabolism, the experiences gained during the development of PET may help to accelerate translation of DNP-MRSI into routine patient imaging.