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Hyperpolarized [13C]pyruvate + [15N]urea is an investigational metabolic MRI imaging agent combination developed at the University of California, San Francisco (UCSF). It consists of two hyperpolarized stable-isotope labeled small molecules: [1-13C]pyruvate and [13C,15N2]urea. This diagnostic modality utilizes hyperpolarization to increase the MRI signal intensity by over 100,000-fold, allowing for real-time in vivo monitoring of tumor metabolism and perfusion. The pyruvate component is used to measure glycolytic flux, specifically the conversion of pyruvate to lactate (kPL), which is often elevated in aggressive tumors. The urea component serves as a perfusion marker to assess blood flow and vascularity within the tissue. It is currently being evaluated in Phase 2 clinical trials for patients with prostate cancer, particularly those undergoing or following radiation therapy, to assess treatment response and detect recurrence.
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