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Hyperpolarized 13C-pyruvate is an investigational diagnostic imaging agent used in metabolic magnetic resonance spectroscopic imaging (MRSI) to non-invasively monitor real-time brain energy metabolism. Developed by the University of Maryland, Baltimore, it is specifically being evaluated in Phase 1 clinical trials for patients with traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH). The agent consists of [1-13C]pyruvate that has undergone dissolution dynamic nuclear polarization (DNP) to significantly enhance its magnetic resonance signal. Following intravenous administration, the agent acts as a metabolic tracer, allowing clinicians to track its conversion into lactate via lactate dehydrogenase (LDH) and into bicarbonate via the pyruvate dehydrogenase (PDH) complex. This metabolic profiling helps identify mitochondrial dysfunction and metabolic crises in the injured brain, potentially improving the diagnosis and characterization of secondary brain injuries.
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