RT Journal Article SR Electronic T1 Current and Potential Applications of Clinical 13C MR Spectroscopy JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 341 OP 344 DO 10.2967/jnumed.107.045112 VO 49 IS 3 A1 John Kurhanewicz A1 Robert Bok A1 Sarah J. Nelson A1 Daniel B. Vigneron YR 2008 UL http://jnm.snmjournals.org/content/49/3/341.abstract AB In this article, the current and potential clinical roles of 13C magnetic resonance spectroscopy (MRS) and 13C magnetic resonance spectroscopic imaging are presented, with a focus on applications to prostate cancer and hyperpolarized 13C spectroscopic imaging. The advantages of 13C MRS have been its chemical specificity and lack of background signal, with the major disadvantage being its inherently low sensitivity and the subsequent inability to acquire data at a high-enough spatial and temporal resolution to be routinely applicable in the clinic. The approaches to improving the sensitivity of 13C spectroscopy have been to perform proton decoupling and to use endogenous 13C-labeled or enhanced metabolic substrates. With these nominal increases in signal-to-noise ratio, 13C MRS using labeled metabolic substrates has shown diagnostic promise in patients and has been approved by the Food and Drug Administration. The development of technology that applies dynamic nuclear polarization to generate hyperpolarized 13C-labeled metabolic substrates, and the development of a process for delivering them into living subjects, have totally changed the clinical potential of MRS of 13C-labeled metabolic substrates. Preliminary preclinical studies in a model of prostate cancer have demonstrated the potential clinical utility of hyperpolarized 13C MRS.