Prospective pilot study reveals feasibility and elevated splenic lactate conversion in advanced diffuse large B-cell lymphoma, indicating potential for metabolic disease assessment.
Key Points
To assess the feasibility of hyperpolarized [1-13C]pyruvate MRI/MRS for characterizing splenic metabolism in advanced diffuse large B-cell lymphoma and explore correlations with 18F-FDG PET/CT metrics.
Prospectively evaluated 5 treatment-naïve patients with Lugano Stage III–IV diffuse large B-cell lymphoma and splenic involvement alongside 4 reference participants without visual splenic abnormalities.
Acquired 3.0 T hyperpolarized [1-13C]pyruvate MRI/MRS dynamic data to calculate the apparent pyruvate-to-lactate exchange rate constant (kPL) and metabolite area-under-the-curve ratios for comparison with PET/CT standardized uptake values.
All 5 patients successfully completed hyperpolarized 13C imaging without adverse events, with kinetic modeling feasible in 4 datasets.
Patients with lymphoma exhibited a 2.7-fold higher median spleen volume, a 2.4-fold higher median kPL (p = 0.081), and a 5.3-fold higher lactate/total carbon ratio (p = 0.114) than reference participants.
Exploratory analyses showed non-significant positive correlations between kPL and splenic PET metrics (SUVmax and spleen-to-liver ratio: ρ = 1.00, p = 0.083 for both).