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Metabolic MRI with hyperpolarized [1-¹³C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke.

ABSTRACT: Acute ischemic stroke patients benefit from reperfusion in a short time-window after debut. Later treatment may be indicated if viable brain tissue is demonstrated and this outweighs the inherent risks of late reperfusion. Magnetic resonance imaging (MRI) with hyperpolarized [1-¹³C]pyruvate is an emerging technology that directly images metabolism. Here, we investigated its potential to detect viable tissue in ischemic stroke. Stroke was induced in pigs by intracerebral injection of endothelin 1. During ischemia, the rate constant of pyruvate-to-lactate conversion, k_PL, was 52% larger in penumbra and 85% larger in the infarct compared to the contralateral hemisphere (P = 0.0001). Within the penumbra, the k_PL was 50% higher in the regions that later infarcted compared to non-progressing regions (P = 0.026). After reperfusion, measures of pyruvate-to-lactate conversion were slightly decreased in the infarct compared to contralateral. In addition to metabolic imaging, we used hyperpolarized pyruvate for perfusion-weighted imaging. This was consistent with conventional imaging for assessment of infarct size and blood flow. Lastly, we confirmed the translatability of simultaneous assessment of metabolism and perfusion with hyperpolarized MRI in healthy volunteers. In conclusion, hyperpolarized [1-¹³C]pyruvate may aid penumbral characterization and increase access to reperfusion therapy for late presenting patients.

SUBMITTER: Bogh N

PROVIDER: S-EPMC8756460 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Metabolic MRI with hyperpolarized [1-<sup>13</sup>C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke.

Bøgh Nikolaj N Olin Rie B RB Hansen Esben Ss ES Gordon Jeremy W JW Bech Sabrina K SK Bertelsen Lotte B LB Sánchez-Heredia Juan D JD Blicher Jakob U JU Østergaard Leif L Ardenkjær-Larsen Jan H JH Bok Robert A RA Vigneron Daniel B DB Laustsen Christoffer C

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism 20210520 11

Acute ischemic stroke patients benefit from reperfusion in a short time-window after debut. Later treatment may be indicated if viable brain tissue is demonstrated and this outweighs the inherent risks of late reperfusion. Magnetic resonance imaging (MRI) with hyperpolarized [1-<sup>13</sup>C]pyruvate is an emerging technology that directly images metabolism. Here, we investigated its potential to detect viable tissue in ischemic stroke. Stroke was induced in pigs by intracerebral injection of e ...[more]

PMID: 34013807

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Project description:BackgroundHyperpolarized 13 C MRI quantitatively measures enzyme-catalyzed metabolism in cancer and metabolic diseases. Whole-abdomen imaging will permit dynamic metabolic imaging of several abdominal organs simultaneously in healthy and diseased subjects.PurposeImage hyperpolarized [1-13 C]pyruvate and products in the abdomens of healthy volunteers, overcoming challenges of motion, magnetic field variations, and spatial coverage. Compare hyperpolarized [1-13 C]pyruvate metabolism across abdominal organs of healthy volunteers.Study typeProspective technical development.SubjectsA total of 13 healthy volunteers (8 male), 21-64 years (median 36).Field strength/sequenceA 3 T. Proton: T1 -weighted spoiled gradient echo, T2 -weighted single-shot fast spin echo, multiecho fat/water imaging. Carbon-13: echo-planar spectroscopic imaging, metabolite-specific echo-planar imaging.AssessmentTransmit magnetic field was measured. Variations in main magnetic field (ΔB0 ) determined using multiecho proton acquisitions were compared to carbon-13 acquisitions. Changes in ΔB0 were measured after localized shimming. Improvements in metabolite signal-to-noise ratio were calculated. Whole-organ regions of interests were drawn over the liver, spleen, pancreas, and kidneys by a single investigator. Metabolite signals, time-to-peak, decay times, and mean first-order rate constants for pyruvate-to-lactate (kPL ) and alanine (kPA ) conversion were measured in each organ.Statistical testsLinear regression, one-sample Kolmogorov-Smirnov tests, paired t-tests, one-way ANOVA, Tukey's multiple comparisons tests. P ≤ 0.05 considered statistically significant.ResultsProton ΔB0 maps correlated with carbon-13 ΔB0 maps (slope = 0.93, y-intercept = -2.88, R2 = 0.73). Localized shimming resulted in mean frequency offset within ±25 Hz for all organs. Metabolite SNR significantly increased after denoising. Mean kPL and kPA were highest in liver, followed by pancreas, spleen, and kidneys (all comparisons with liver were significant).Data conclusionWhole-abdomen coverage with hyperpolarized carbon-13 MRI was feasible despite technical challenges. Multiecho gradient echo 1 H acquisitions accurately predicted chemical shifts observed using carbon-13 spectroscopy. Carbon-13 acquisitions benefited from local shimming. Metabolite energetics in the abdomen compiled for healthy volunteers can be used to design larger clinical trials in patients with metabolic diseases.Evidence level2 TECHNICAL EFFICACY: Stage 1.

Dataset Information

Metabolic MRI with hyperpolarized [1-¹³C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke.

Publications

Metabolic MRI with hyperpolarized [1-<sup>13</sup>C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke.

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OmicsDI is part of the ELIXIR infrastructure

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Dataset Information

Metabolic MRI with hyperpolarized [1-13C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke.

Publications

Metabolic MRI with hyperpolarized [1-<sup>13</sup>C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Metabolic MRI with hyperpolarized [1-¹³C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke.