Measuring Tumor Metabolism in Pediatric Diffuse Intrinsic Pontine Glioma Using Hyperpolarized Carbon-13 MR Metabolic Imaging

Figure 2

Representative hyperpolarized ¹³C data from a rat ( total) bearing DIPG. (a) Axial T₂-weighted image of the brainstem with a spectral grid overlay for 3D ¹³C MRSI data. Pink and light blue boxes represent voxels encompassing the T₂-hyperintense lesion and contralateral brain tissue, respectively. (b) The corresponding hyperpolarized ¹³C spectra with an in-plane spatial resolution of 2 × 2 × 5.4 mm³. Voxels encompassing the T₂-hyperintense lesion (pink boxes) exhibited elevated lactate levels compared to those of the contralateral brain tissue (light blue boxes). (c) The map of normalized lactate shows elevated lactate signal in DIPG. (d) The corresponding slice from H&E staining (top) and the zoomed-in H&E image (bottom) demonstrate infiltrative, viable DIPG. The blue and green arrows in (c) and (d) indicate pons and cerebellum of the rat brain, respectively.

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