Glioblastoma (GBM) is a highly malignant and heterogeneous tumor of the central nervous
system. Despite a large variety of existing treatment approaches1, prognosis and outcome
are still devastating. However, therapy efficacy often depends on the tumor
microenvironment such as extracellular pH and oxygenation and is often driven by tumor
metabolism. Here, we studied GBM by multimodal imaging of pH2,3, pyruvate-lactate
conversion and hypoxia using hyperpolarized (HP) 13C-MRI and 18F-PET to investigate links
between hypoxia, pH and lactate production in these tumors.