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Hyperpolarized [1\u2010\n 13<\/jats:sup>\n C]pyruvate MRI\/MRS may provide metabolic information beyond morphologic assessment.\n <\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n \n To assess hyperpolarized [1\u2010\n 13<\/jats:sup>\n C]pyruvate MRI\/MRS's feasibility for evaluating splenic metabolism in advanced\u2010stage diffuse large B\u2010cell lymphoma (DLBCL), and explore associations with\n 18<\/jats:sup>\n F\u2010FDG PET\/CT metrics.\n <\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Prospective pilot study.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n 5 treatment\u2010na\u00efve patients (4 male, 1 female) with Lugano Stage III\u2013IV DLBCL and splenic involvement\/splenomegaly and four female reference participants from a published cervical cancer study without visually apparent splenic abnormality on imaging.<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n \n 3.0\u2009T hyperpolarized [1\u2010\n 13<\/jats:sup>\n C]pyruvate MRI\/MRS using a multi\u2010echo gradient\u2010echo spiral chemical shift imaging sequence with IDEAL\u2010based reconstruction.\n <\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n \n Parameters included the apparent pyruvate\u2010to\u2010lactate exchange rate constant (\n k<\/jats:italic>\n PL<\/jats:sub>\n ) and area\u2010under\u2010the\u2010curve ratios of lactate, alanine, and bicarbonate normalized to total carbon. PET\/CT metrics included splenic maximum standardized uptake value (SUVmax) and spleen\u2010to\u2010liver ratio (SLR).\n <\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Mann\u2013Whitney U tests compared groups. Spearman coefficients assessed associations between hyperpolarized\n 13<\/jats:sup>\n C and PET\/CT metrics.\n p<\/jats:italic>\n value <\u20090.05 indicated significance.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All five patients completed hyperpolarized\n 13<\/jats:sup>\n C MRI\/MRS acquisition without adverse events; four had dynamic datasets for kinetic analysis. Median spleen volume was 2.7\u2010fold higher in DLBCL than in the reference cohort. Median\n k<\/jats:italic>\n PL<\/jats:sub>\n and lactate\/total carbon ratio were 2.4\u2010fold and 5.3\u2010fold higher, respectively, but not significant (\n p<\/jats:italic>\n \u2009=\u20090.081 and\n p<\/jats:italic>\n \u2009=\u20090.114). Exploratory correlations were observed between\n k<\/jats:italic>\n PL<\/jats:sub>\n and each PET metric (SUVmax and SLR;\n \u03c1<\/jats:italic>\n \u2009=\u20091.00;\n p<\/jats:italic>\n \u2009=\u20090.083 for both), and between lactate\/total carbon ratio and each PET metric (\n \u03c1<\/jats:italic>\n \u2009=\u20090.80;\n p<\/jats:italic>\n \u2009=\u20090.333 for both); none reached significance.\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n \n Hyperpolarized [1\u2010\n 13<\/jats:sup>\n C]pyruvate MRI\/MRS was completed in all five patients, with kinetic analysis feasible in four. Findings showed numerically higher splenic pyruvate\u2010to\u2010lactate metabolism and nonsignificant positive correlations with FDG\u2010PET activity, warranting larger studies.\n <\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 4.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 1.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70524","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:25:00Z","timestamp":1788931500000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hyperpolarized\n \n 13<\/sup>\n C\n <\/scp>\n Pyruvate\n MRI<\/scp>\n \/\n MRS<\/scp>\n for Characterizing Splenic Metabolism in Advanced Diffuse Large B\u2010Cell Lymphoma: A Pilot 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