Hyperpolarized Carbon C 13 Pyruvate in Diagnosing Glioma in Patients with Brain Tumors

Inclusion Criteria

• Written informed consent will be obtained from each participants including healthy volunteers.
• Healthy volunteers will not have contra-indications to MR scanning, but will otherwise not be subject to other selection criteria.
• Patients will be enrolled in study # 2011-0370 (NCT03458676), the Stereotactic RadPath trial, or can be recruited independently
• Patient is > 18 years old, agrees to participate in the clinical study and to complete all required visits and evaluations. The pediatric population has a different disease profile from the glioma patients we hope to recruit. To reduce heterogeneity in the patient population we will not consider patients younger than 18 for this study.
• Patient is a candidate for cerebral tumor resection with lesion suspected to be or previously biopsy proven to be a primary brain tumor.
• Patient is able to understand and give consent to participation in the study.
• Patient agrees to undergo, prior to the procedure, magnetic resonance imaging (MRI, within 14 days and preferably with 3 days of the planned procedure) with perfusion, diffusion and spectroscopic imaging.
• Patient has a glomerular filtration rate (GFR) > 60. In patients with moderate renal failure (GFR 30-60), an alternate injection with 2 times half-dose multihance (gadobenate dimeglumine) or gadovist (gadobutrol) will be considered, if a contrast exam is deemed clinically necessary.
• Specifically for this study: Patient is willing to give signed informed consent for C13-Pyruvate MR Spectroscopy.

Exclusion Criteria

• Healthy volunteers will be screened using same process but will otherwise not be subject to other selection criteria.
• The patient is found to have unfavorable anatomy to indicate that stereotactic biopsy could not be safely performed.
• Pacemakers, electronic stimulation, metallic foreign bodies and devices and/or other conditions that are not MR safe, which include but are not limited to: * Electronically, magnetically, and mechanically activated implants * Ferromagnetic or electronically operated active devices like automatic cardioverter defibrillators and cardiac pacemakers * Metallic splinters in the eye * Ferromagnetic hemostatic clips in the central nervous system (CNS) or body * Cochlear implants * Other pacemakers, e.g., for the carotid sinus * Insulin pumps and nerve stimulators * Non-MR safe lead wires * Prosthetic heart valves (if dehiscence is suspected) * Non-ferromagnetic stapedial implants * Pregnancy * Claustrophobia that does not readily respond to oral medication
• Prior brain tumor treatment, including surgical resection, radiation therapy or chemotherapy for a primary brain neoplasm. Previous biopsy will not disqualify the patient from participation. Remote history (> 6 month) of non-CNS malignancy in remission, without evidence of current/ prior brain metastasis, will also not disqualify patient from participating.
• A history of clinically significant electrocardiogram (ECG) abnormalities, including QT prolongation (Fridericia's correction formula [QTcF] > 500 ms), a family history of prolonged QT interval syndrome, or myocardial infarction (MI) within 6 months of study entry. Patients with rate-controlled atrial fibrillation/flutter will be allowed on study