GPT and cancer: The now called “Warburg effect” was the first description of a metabolic phenotype in tumors whereby the cells are metabolizing glucose anaerobically.16 This phenomenon has been widely used in hyperpolarized magnetic resonance for cancer diagnosis.17 As the terminal product of glycolysis, pyruvate can readily diffuse into cancer cells and convert into lactate via Lactate dehydrogenase (LDH), alanine via alanine transaminase (ALT) or to metabolites involved in the tricarboxylic acid (TCA) cycle in mitochondria.