Abnormal metabolism is a hallmark of cancer. The current study demonstrates use of a novel imaging technique for fast, simultaneous pH- and hypoxia-weighted images using multi-echo amine chemical exchange saturation transfer spin-and-gradient-echo echoplanar imaging (ME-aCEST-SAGE-EPI). From these data, we demonstrate use of a “glycolytic index”, quantified as the ratio of relative acidity to metabolic rate of oxygen, in estimating metabolically active tumor tissue in 15 patients with gliomas. The glycolytic index showed unique heterogeneous metabolic contrast within the tumor region, and was able to easily stratify tumor from healthy tissue when compared with other imaging techniques.
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