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Purpose To develop a novel post‐processing pipeline for hyperpolarized (HP) 13 C MRSI that integrates tensor denoising and correction to measure pyruvate‐to‐lactate conversion rates (k PL ) in patients with liver tumors. Methods Seven HP 13 C MR scans of progressing liver tumors were acquired using a custom 13 C surface transmit/receive coil and the echo‐planar spectroscopic imaging (EPSI) data analysis included B 0 correction, tensor rank truncation, and zero‐ and first‐order phase corrections to recover metabolite signals that would otherwise be obscured by spectral noise as well as a correction for inhomogeneous transmit ( ) using a map aligned to the coil position for each patient scan. Processed HP data and corrected flip angles were analyzed with an inputless two‐site exchange model to calculate k PL . Results Denoising averages SNR increases of pyruvate, lactate, and alanine were 37.4‐, 34.0‐, and 20.1‐fold, respectively, with lactate and alanine dynamics most noticeably recovered and better defined. In agreement with Monte Carlo simulations, over‐flipped regions underestimated k PL and under‐flipped regions overestimated k PL . correction addressed this issue. Conclusion The new HP 13 C EPSI post‐processing pipeline integrated tensor denoising and correction to measure k PL in patients with liver tumors. These technical developments not only recovered metabolite signals in voxels that did not receive the prescribed flip angle, but also increased the extent and accuracy of k PL estimations throughout the tumor and adjacent regions including normal‐appearing tissue and additional lesions.
Lee et al. (Sat,) studied this question.