{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:10:46Z","timestamp":1788966646968,"version":"build-2803163510"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["MOST 109-2628-B-182A-007-"],"award-info":[{"award-number":["MOST 109-2628-B-182A-007-"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["MOST 110-2628-B-182A-018-"],"award-info":[{"award-number":["MOST 110-2628-B-182A-018-"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["MOST 111-2628-B-182A-012-"],"award-info":[{"award-number":["MOST 111-2628-B-182A-012-"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 112-2314-B-182A-127 -MY3"],"award-info":[{"award-number":["NSTC 112-2314-B-182A-127 -MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CLRPG3K0024"],"award-info":[{"award-number":["CLRPG3K0024"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG3M0731"],"award-info":[{"award-number":["CMRPG3M0731"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol Exp"],"abstract":"Abstract<\/jats:title>\n Background<\/jats:title>\n Monitoring pyruvate metabolism in the spleen is important for assessing immune activity and achieving successful radiotherapy for cervical cancer due to the significance of the abscopal effect. We aimed to explore the feasibility of utilizing hyperpolarized (HP) [1-13<\/jats:sup>C]-pyruvate magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) to evaluate pyruvate metabolism in the human spleen, with the aim of identifying potential candidates for radiotherapy in cervical cancer.<\/jats:p>\n <\/jats:sec>\n Methods<\/jats:title>\n This prospective study recruited six female patients with cervical cancer (median age 55\u00a0years; range 39\u201360) evaluated using HP [1-13<\/jats:sup>C]-pyruvate MRI\/MRS at baseline and 2\u00a0weeks after radiotherapy. Proton (1<\/jats:sup>H) diffusion-weighted MRI was performed in parallel to estimate splenic cellularity. The primary outcome was defined as tumor response to radiotherapy. The Student t<\/jats:italic>-test was used for comparing 13<\/jats:sup>C data between the groups.<\/jats:p>\n <\/jats:sec>\n Results<\/jats:title>\n The splenic HP [1-13<\/jats:sup>C]-lactate-to-total carbon (tC) ratio was 5.6-fold lower in the responders than in the non-responders at baseline (p<\/jats:italic>\u2009=\u20090.009). The splenic [1-13<\/jats:sup>C]-lactate-to-tC ratio revealed a 1.7-fold increase (p<\/jats:italic>\u2009=\u20090.415) and the splenic [1-13<\/jats:sup>C]-alanine-to-tC ratio revealed a 1.8-fold increase after radiotherapy (p<\/jats:italic>\u2009=\u20090.482). The blood leukocyte differential count revealed an increased proportion of neutrophils two weeks following treatment, indicating enhanced immune activity (p<\/jats:italic>\u2009=\u20090.013). The splenic apparent diffusion coefficient values between the groups were not significantly different.<\/jats:p>\n <\/jats:sec>\n Conclusions<\/jats:title>\n This exploratory study revealed the feasibility of HP [1-13<\/jats:sup>C]-pyruvate MRS of the spleen for evaluating baseline immune potential, which was associated with clinical outcomes of cervical cancer after radiotherapy.<\/jats:p>\n <\/jats:sec>\n Trial registration<\/jats:title>\n ClinicalTrials.gov NCT04951921<\/jats:ext-link>, registered 7 July 2021.<\/jats:p>\n <\/jats:sec>\n Relevance statement<\/jats:title>\n This prospective study revealed the feasibility of using HP 13<\/jats:sup>C MRI\/MRS for assessing pyruvate metabolism of the spleen to evaluate the patients\u2019 immune potential that is associated with radiotherapeutic clinical outcomes in cervical cancer.<\/jats:p>\n <\/jats:sec>\n Key points<\/jats:title>\n \u2022 Effective radiotherapy induces abscopal effect via altering immune metabolism.<\/jats:p>\n \u2022 Hyperpolarized 13<\/jats:sup>C MRS evaluates patients\u2019 immune potential non-invasively.<\/jats:p>\n \u2022 Pyruvate-to-lactate conversion in the spleen is elevated following radiotherapy.<\/jats:p>\n <\/jats:sec>\n Graphical Abstract<\/jats:title>\n \n <\/jats:sec>","DOI":"10.1186\/s41747-024-00445-1","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:02:31Z","timestamp":1712707351000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hyperpolarized [1-13C]-pyruvate MRS evaluates immune potential and predicts response to radiotherapy in cervical cancer"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-1058","authenticated-orcid":false,"given":"Gigin","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Yi","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Chieh","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Chieh","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yenpo","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Ying","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Yen","family":"Chai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert P.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu-Chen","family":"Yen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Hang","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chyong-Huey","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"445_CR1","doi-asserted-by":"publisher","first-page":"660","DOI":"10.6004\/jnccn.2020.0027","volume":"18","author":"NR Abu-Rustum","year":"2020","unstructured":"Abu-Rustum NR, Yashar CM, Bean S et al (2020) NCCN guidelines insights: cervical cancer, Version 1.2020. 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Approval was granted by Chang Gung Medical Foundation Institutional Review Board (CGMH IRB, No. 201702080A0, registered 1 February 2018), Taiwan Food and Drug Administration (TFDA, No. 1106805404; 110IND02017, registered 7 May 2021) and ClinicalTrials.gov<\/i> (NCT04951921, registered 7 July 2021). The participants recruited in this trial were fully explained the study information by Dr. Gigin Lin and Dr. Chun-Chieh Wang. Informed consent was obtained from all individual participants included in this study, and the first case was started on 15 July 2021.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Albert P Chen is a Principal Scientist of GE Healthcare Canada and does not have any fiduciary responsibility. The other authors declare no conflict of interest. Gigin Lin and Ching-Yi Hsieh analyzed and controlled the data and were not employed by or a consultant for a company in the medical industry.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"46"}}