A novel treatment approach for glioblastoma is based on mesenchymal stem cell (MSC)-mediated gene therapies whereby cell accumulation can be influenced by the tumor microenvironment. Here, we demonstrate the ability to image pH, metabolic pyruvate-lactate conversion and hypoxia in glioblastoma using hyperpolarized [1,5-13C2,3,6,6,6-D4]zymonic acid-MRSI, [1-13C]pyruvate-MRI and [18F]FMISO-PET as predictors for hypoxia-targeted sodium-iodide-symporter (NIS)-expression of tumor-infiltrating MSCs assessed by 124I-PET. Observed hypoxia (SUVmean = 0.49±0.05) was confirmed by histology and occurred together with increased lactate-production (AUCmean = 1.14±0.17) and mild acidification (pHmean = 7.34±0.02). This shows to be a suitable environment for NIS-MSC-activity, thereby allowing efficient therapy.
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