PT  - JOURNAL ARTICLE
AU  - Autry, A.W.
AU  - Park, I.
AU  - Kline, C.
AU  - Chen, H.-Y.
AU  - Gordon, J.W.
AU  - Raber, S.
AU  - Hoffman, C.
AU  - Kim, Y.
AU  - Okamoto, K.
AU  - Vigneron, D.B.
AU  - Lupo, J.M.
AU  - Prados, M.
AU  - Li, Y.
AU  - Xu, D.
AU  - Mueller, S.
TI  - Pilot Study of Hyperpolarized <sup>13</sup>C Metabolic Imaging in Pediatric Patients with Diffuse Intrinsic Pontine Glioma and Other CNS Cancers
AID  - 10.3174/ajnr.A6937
DP  - 2021 Jan 01
TA  - American Journal of Neuroradiology
PG  - 178--184
VI  - 42
IP  - 1
4099  - http://www.ajnr.org/content/42/1/178.short
4100  - http://www.ajnr.org/content/42/1/178.full
SO  - Am. J. Neuroradiol.2021 Jan 01; 42
AB  - BACKGROUND AND PURPOSE: Pediatric CNS tumors commonly present challenges for radiographic interpretation on conventional MR imaging. This study sought to investigate the safety and tolerability of hyperpolarized carbon-13 (HP-13C) metabolic imaging in pediatric patients with brain tumors.MATERIALS AND METHODS: Pediatric patients 3 to 18 years of age who were previously diagnosed with a brain tumor and could undergo MR imaging without sedation were eligible to enroll in this safety study of HP [1-13C]pyruvate. Participants received a one-time injection of HP [1-13C]pyruvate and were imaged using dynamic HP-13C MR imaging. We assessed 2 dose levels: 0.34 mL/kg and the highest tolerated adult dose of 0.43 mL/kg. Participants were monitored throughout imaging and for 60 minutes postinjection, including pre- and postinjection electrocardiograms and vital sign measurements.RESULTS: Between February 2017 and July 2019, ten participants (9 males; median age, 14 years; range, 10–17 years) were enrolled, of whom 6 completed injection of HP [1-13C]pyruvate and dynamic HP-13C MR imaging. Four participants failed to undergo HP-13C MR imaging due to technical failures related to generating HP [1-13C]pyruvate or MR imaging operability. HP [1-13C]pyruvate was well-tolerated in all participants who completed the study, with no dose-limiting toxicities or adverse events observed at either 0.34 (n = 3) or 0.43 (n = 3) mL/kg. HP [1-13C]pyruvate demonstrated characteristic conversion to [1-13C]lactate and [13C]bicarbonate in the brain. Due to poor accrual, the study was closed after only 3 participants were enrolled at the highest dose level.CONCLUSIONS: Dynamic HP-13C MR imaging was safely performed in 6 pediatric patients with CNS tumors and demonstrated HP [1-13C]pyruvate brain metabolism.aSNRapparent total SNREPSIecho-planar spectroscopic imagingDIPGdiffuse intrinsic pontine gliomaHP-13Chyperpolarized carbon-13