Did you put the parking brake on, or 4x4 high and stand on the brakes, and load the drivetrain while on the lift? Brake stand while on the pavement recreate it? Of course vary the throttle during the brake stand to see if the noise shows up. Careful with max 2 min of this so you don't overheat the auto trans.
Metallic noise to me is something hitting, loose converter bolts, broken flexplate, locked up u-joints, bad front hub bearings, center bearing or rubber around it bad... 45MPH is where the TCC locks up and increases engine load at any throttle. The increased load can move the engine on the mounts.
I would look close at the fan and fan shroud for rubbing as well as the trans cooler lines etc. being too close to the fan. I had an engine mount get coated in biodiesel from a injector body leak and the mount has sagged. It rubbed the fan only under harder throttle. Made a lot of noise when I was on it just right and took a significant amount off the shroud on it's own. Fan shroud clearance from the small OEM fan diameter takes into account complete engine mount failure. We are running bigger fans that have trouble with less than total failure and some require shroud trimming from the start.
Back to the exhaust hitting - these engines move a lot even with good mounts. Frame is not the only place the exhaust can hit as it can hit the cab with the downpipe. Think beyond the exhaust: look at the hood for the CDR pipes hitting it although that hitting and going clean through the hood insulation never created noise for me.