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Considering the high dose of pyruvate used in hyperpolarized\n                      <jats:sup>13<\/jats:sup>\n                      C\u2010pyruvate studies, circulating\n                      <jats:sup>13<\/jats:sup>\n                      C\u2010pyruvate and the resulting\n                      <jats:sup>13<\/jats:sup>\n                      C\u2010lactate in plasma may influence subsequent pyruvate metabolism, yet the guidance on consecutive injections does not exist. This study is to characterize blood pyruvate and lactate dynamics following [1\u2010\n                      <jats:sup>13<\/jats:sup>\n                      C]pyruvate injection and to evaluate the repeatability of\n                      <jats:sup>13<\/jats:sup>\n                      C neuroimaging with consecutive pyruvate injections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sixteen healthy adults (mean age, 39.0\u2009\u00b1\u200915.9\u2009years; 8 men) underwent blood sampling or MRI. Eight participants received bolus injections of non\u2010hyperpolarized [1\u2010\n                      <jats:sup>13<\/jats:sup>\n                      C]pyruvate following both overnight fasting and postprandial states. Blood samples were collected at baseline and up to 60\u2009min post\u2010injection to quantify pyruvate and lactate concentrations and\n                      <jats:sup>13<\/jats:sup>\n                      C fractional enrichments using mass spectrometry. In parallel, eight participants underwent\n                      <jats:sup>13<\/jats:sup>\n                      C\/\n                      <jats:sup>1<\/jats:sup>\n                      H MRI that included two injections of hyperpolarized [1\u2010\n                      <jats:sup>13<\/jats:sup>\n                      C]pyruvate with intervals of 6\u201355\u2009min for time\u2010resolved measurement of\n                      <jats:sup>13<\/jats:sup>\n                      C\u2010pyruvate and\n                      <jats:sup>13<\/jats:sup>\n                      C\u2010lactate in the brain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Plasma\n                      <jats:sup>13<\/jats:sup>\n                      C\u2010pyruvate peaked within 30\u2009s and returned to baseline within 5\u201310\u2009min, while\n                      <jats:sup>13<\/jats:sup>\n                      C\u2010lactate peaked at 2\u20133\u2009min. Lactate\n                      <jats:sup>13<\/jats:sup>\n                      C enrichment was higher in fasting versus fed states, and total lactate concentration in blood was unchanged by pyruvate injection. Brain\n                      <jats:sup>13<\/jats:sup>\n                      C\u2010lactate\/pyruvate showed excellent repeatability (ICC\u2009=\u20090.9842), with all points within the 95% Bland\u2013Altman limits. Voxel\u2010wise Pearson's correlation between injections was 0.72\u2009\u00b1\u20090.22 and within\u2010subject coefficient of variation was 17.6%\u2009\u00b1\u20094.6%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Consecutive injections of hyperpolarized [1\u2010\n                      <jats:sup>13<\/jats:sup>\n                      C]pyruvate yield repeatable blood and brain metabolic measurements in humans, supporting multi\u2010injection protocols in\n                      <jats:sup>13<\/jats:sup>\n                      C MRI studies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mrm.70402","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:25:37Z","timestamp":1777004737000},"page":"548-556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Repeatability of Metabolic Imaging With Hyperpolarized Pyruvate: Back\u2010to\u2010Back Neuroimaging and Blood Analysis"],"prefix":"10.1002","volume":"96","author":[{"given":"Jun","family":"Chen","sequence":"first","affiliation":[{"name":"Advanced Imaging Research Center, the University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1384-4037","authenticated-orcid":false,"given":"Sung\u2010Han","family":"Lin","sequence":"additional","affiliation":[{"name":"Advanced Imaging Research Center, the University of Texas Southwestern Medical Center  Dallas Texas 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