NAD is one of the most important coenzymes in the cell. Studies have linked NAD biosynthesis to pathophysiological mechanisms in several diseases, such as diabetes, non-alcoholic fatty liver disease, retinal degeneration, multiple sclerosis, Alzheimer’s disease, and cancer. However, current ability to image NAD metabolism in vivo is severely lacking. It is either limited by penetration depth (i.e. optical imaging) or relies on radioactive tracer uptakes without providing direct information about metabolic transformations (i.e. PET/SPECT). MRI suffers from limited signal to noise ratio. In mammals, NAD is synthesized from vitamin B3 precursors (including nicotinamide). Similarly to how hyperpolarization of carbon-13 pyruvate allows tracking of cancer metabolism, hyperpolarization of isotopically labeled nicotinamide yields the possibility of tracking NAD metabolism in vivo, which could potentially provide crucial information relevant to the aforementioned diseases. Currently in the Yen lab, we are working on making this a possibility, by developing hyperpolarized nitrogen-15 nicotinamide as a contrast agent.