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Creatine-13C is a stable isotope-labeled diagnostic tracer used for the noninvasive assessment of skeletal muscle metabolism. Labeled at the guanidino C-4 position with carbon-13, it serves as a metabolic probe for 13C magnetic resonance spectroscopic imaging (MRSI). Upon oral administration, the tracer is taken up by skeletal muscle via the creatine transporter and subsequently phosphorylated into 13C-phosphocreatine (PCr) by creatine kinase. This allows for the local measurement of creatine uptake, turnover, and the PCr/total creatine ratio in individual muscles. Developed by Radboud University Nijmegen Medical Center, it has been utilized in Phase 2 exploratory research to characterize metabolic biomarkers in healthy volunteers and patients with muscular dystrophies, such as facioscapulohumeral muscular dystrophy (FSHD).
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