• Novel magnetic resonance-based imaging technique.
• Provides 3D maps of active metabolism in 20 min scan.
• Detects metabolism of nutrients/substrates such as glucose or acetate labeled with the stable isotope deuterium (2H).
• Can be easily implemented on existing 3T and 7T MRI scanners; very robust method: potential for push-button imaging.
• Substrates: 2H-labeled substrates and nutrients are commercially available and affordable.
• DMI has been performed in animals and humans, using 2Hglucose and 2H-acetate, imaging brain and liver metabolism.
• After an oral dose of 2H-labeled glucose, DMI provided unprecedented image contrast based on glucose metabolism in a patient with GBM brain tumor.
• Can be applied in other organs and tissues and to any pathology, intervention or treatment with a metabolic component.
• IP status: PRV filed.
• Innovators: Henk De-Feyter, Robin de Graaf.

DMI visualizes the Warburg effect in a patient with GBM after oral 2H-glucose intake.

a) Clinical MR images acquired in a patient diagnosed with GBM in the right frontal lobe.

b, c) T2- weighted MRI and overlaid DMI maps in two slices that contain the tumor lesion. The MRI and DMI data shown in (c) correspond to the slice position of the clinical MR scans in (a). DMI maps show homogenous distribution of 2H-glucose across the slices but lower levels of 2Hlabeled glutamate+glutamine (Glx) and a higher concentration of 2H-labeled lactate in the tumor lesion compared to normal-appearing brain.

d) 2H NMR spectra from selected locations depicted in the T2W MR image, including tissue (1, 3) within the lesion as seen on T1W CE; (2) from normal-appearing occipital lobe and (4) containing cerebrospinal fluid from the left lateral ventricle.

e) 3D illustration of combined MRI and DMI of the lactate/Glx ratio representing the spatial distribution of the Warburg effect.