2H magnetic resonance spectroscopic imaging has been shown recently to be a viable technique for metabolic imaging in the clinic. We show here that 2H MR spectroscopy and spectroscopic imaging measurements of [2,3-2H2]
malate production from [2,3-2H2]
fumarate can be used to detect
tumor cell death in vivo via the production of labeled
malate. Production of [2,3-2H2]
malate, following injection of [2,3-2H2]
fumarate (1 g/kg) into
tumor-bearing mice, was measured in a murine
lymphoma (EL4) treated with
etoposide, and in human breast (MDA-MB-231) and colorectal (Colo205) xenografts treated with a TRAILR2 agonist, using surface-coil localized 2H MR spectroscopy at 7 T.
Malate production was also imaged in EL4
tumors using a fast 2H chemical shift imaging sequence. The
malate/
fumarate ratio increased from 0.016 ± 0.02 to 0.16 ± 0.14 in EL4
tumors 48 h after
drug treatment (P = 0.0024, n = 3), and from 0.019 ± 0.03 to 0.25 ± 0.23 in MDA-MB-231
tumors (P = 0.0001, n = 5) and from 0.016 ± 0.04 to 0.28 ± 0.26 in Colo205
tumors (P = 0.0002, n = 5) 24 h after
drug treatment. These increases were correlated with increased levels of cell death measured in excised
tumor sections obtained immediately after imaging. 2H MR measurements of [2,3-2H2]
malate production from [2,3-2H2]
fumarate provide a potentially less expensive and more sensitive method for detecting cell death in vivo than 13C MR measurements of hyperpolarized [1,4-13C2]
fumarate metabolism, which have been used previously for this purpose.