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Hyperpolarized 13C Pyruvate is a diagnostic imaging agent developed by Chang Gung Memorial Hospital for the metabolic assessment of locally advanced cervical cancer. It utilizes dynamic nuclear polarization (DNP) to enhance the carbon-13 magnetic resonance signal by up to 50,000-fold, allowing for the real-time visualization of the conversion of pyruvate to lactate. This metabolic flux, mediated by monocarboxylate transporter 1 (MCT1) and lactate dehydrogenase (LDH), serves as a biomarker for glycolytic activity and treatment response in patients undergoing concurrent chemoradiotherapy (CCRT). The agent is administered intravenously and imaged using specialized MRI and magnetic resonance spectroscopy (MRS) techniques, often in conjunction with MR Fingerprinting (MRF).
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