Harnessing unique metabolic insight from hyperpolarized (HP) 13C MRI, this study describes an integrated approach toward routine cancer staging and restaging using combined HP 13C plus standard of care (SOC) MRI with commercially-available 13C and 1H array coils and a time-efficient adaptive protocol. A series of patients with osseous, liver, nodal metastases, and locally advanced primary tumors suggested HP 13C not only detected high metabolic activity in progressive tumors, but it also revealed inter- and intratumoral metabolic heterogeneity. Results indicated HP 13C-MRI can greatly complement SOC-MRI in assessing therapeutic response and guiding clinical decisions.
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