LDHA and neoplasm: This hypothesis is supported by evidence from studies demonstrating that the expression of LDHA, which encodes a subunit of LDH, correlated positively with tumour grade and negatively with progression-free survival and overall survival.87 As hyperpolarised pyruvate and13C-MRI assesses a reaction catalysed by the enzyme LDH, the imaged lactate is likely to correlate with tumour grade and outcome as well.