Potential Clinical Applications of Hyperpolarized ¹³C and ²H MRI

With modern targeted cancer drugs, not all patients will respond to treatment in the same way. The challenge is to select the most appropriate treatment for an individual patient, which could reduce healthcare costs and improve patient management. MRI with hyperpolarized ¹³C-labelled and ²H-labelled substrates offers potentially unique insights into the metabolism of tumours in the clinic, where these techniques can be used to grade tumours and to both predict and then detect their very early responses to treatment. We discuss here the basic principles of how these metabolic imaging techniques work and give examples of how different labelled substrates can be used, with a focus on those substrates that have already gone into the clinic or are about to go into the clinic.