Fig. 4.

Clinical examples of hyperpolarized [1-¹³C]pyruvate MRI. (a) Representative dynamic ¹³C MRS data of pyruvate and lactate signal in prostate cancer region and contralateral prostate region of a prostate cancer patient, and lactate/pyruvate signal ratio map overlaid on a T₂-weighted ¹H MR image (adapted from Figs. 2 and 4, respectively of Nelson et al.⁴ reprinted with permission from the American Association for the Advancement of Science (AAAS)). (b) HP [1-¹³C]pyruvate, lactate and bicarbonate MR images and a non-selective MR spectrum of the healthy human heart (adapted from Figs. 1 and 3, respectively of Cunningham et al.⁸⁰ reprinted with permission from Wolters Klumer Health, Inc). (c) Comparison of HP [1-¹³C]pyruvate and lactate MR images to contrast-enhanced T₁-weighted MRI and perfusion plasma volume mapping in a patient with recurrent glioblastoma (adapted from Fig. 4 of Miloushev et al.⁸⁵ permission from the American Association for Cancer Research (AACR)).