Metabolic imaging of hyperpolarized [1-13C]pyruvate was performed in four patients with pancreatic ductal adenocarcinoma prior to chemotherapy. Compared to the normal appearing pancreas, higher lactate/pyruvate and lower alanine/pyruvate ratios were seen in the primary tumors. The alanine/lactate ratio, which reflects the relative enzymatic activity and metabolite pool sizes, was reduced 2- to 20-fold in the tumors and provided improved contrast between tumor and normal appearing pancreas over either the lactate/pyruvate or alanine/pyruvate ratio. These results indicate the potential for HP 13C MRI to be a novel tool to stage disease and assess treatment response in pancreatic cancer patients
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