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Frijia F, Flori A, Giovannetti G, Barison A, Menichetti L, Santarelli MF, Positano V. MRI Application and Challenges of Hyperpolarized Carbon-13 Pyruvate in Translational and Clinical Cardiovascular Studies: A Literature Review. Diagnostics (Basel) 2024; 14:1035. [PMID: 38786333 PMCID: PMC11120300 DOI: 10.3390/diagnostics14101035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
Cardiovascular disease shows, or may even be caused by, changes in metabolism. Hyperpolarized magnetic resonance spectroscopy and imaging is a technique that could assess the role of different aspects of metabolism in heart disease, allowing real-time metabolic flux assessment in vivo. In this review, we introduce the main hyperpolarization techniques. Then, we summarize the use of dedicated radiofrequency 13C coils, and report a state of the art of 13C data acquisition. Finally, this review provides an overview of the pre-clinical and clinical studies on cardiac metabolism in the healthy and diseased heart. We furthermore show what advances have been made to translate this technique into the clinic in the near future and what technical challenges still remain, such as exploring other metabolic substrates.
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Affiliation(s)
- Francesca Frijia
- Bioengineering Unit, Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (A.F.); (V.P.)
| | - Alessandra Flori
- Bioengineering Unit, Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (A.F.); (V.P.)
| | - Giulio Giovannetti
- Institute of Clinical Physiology, National Research Council (CNR), 56124 Pisa, Italy; (G.G.); (L.M.); (M.F.S.)
| | - Andrea Barison
- Cardiology and Cardiovascular Medicine Unit, Fondazione Toscana G. Monasterio, 56124 Pisa, Italy;
| | - Luca Menichetti
- Institute of Clinical Physiology, National Research Council (CNR), 56124 Pisa, Italy; (G.G.); (L.M.); (M.F.S.)
| | - Maria Filomena Santarelli
- Institute of Clinical Physiology, National Research Council (CNR), 56124 Pisa, Italy; (G.G.); (L.M.); (M.F.S.)
| | - Vincenzo Positano
- Bioengineering Unit, Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (A.F.); (V.P.)
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2
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Hu JY, Vaziri S, Bøgh N, Kim Y, Autry AW, Bok RA, Li Y, Laustsen C, Xu D, Larson PEZ, Chang S, Vigneron DB, Gordon JW. Investigating cerebral perfusion with high resolution hyperpolarized [1- 13 C]pyruvate MRI. Magn Reson Med 2023; 90:2233-2241. [PMID: 37665726 PMCID: PMC10543485 DOI: 10.1002/mrm.29844] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To investigate high-resolution hyperpolarized (HP) 13 C pyruvate MRI for measuring cerebral perfusion in the human brain. METHODS HP [1-13 C]pyruvate MRI was acquired in five healthy volunteers with a multi-resolution EPI sequence with 7.5 × 7.5 mm2 resolution for pyruvate. Perfusion parameters were calculated from pyruvate MRI using block-circulant singular value decomposition and compared to relative cerebral blood flow calculated from arterial spin labeling (ASL). To examine regional perfusion patterns, correlations between pyruvate and ASL perfusion were performed for whole brain, gray matter, and white matter voxels. RESULTS High resolution 7.5 × 7.5 mm2 pyruvate images were used to obtain relative cerebral blood flow (rCBF) values that were significantly positively correlated with ASL rCBF values (r = 0.48, 0.20, 0.28 for whole brain, gray matter, and white matter voxels respectively). Whole brain voxels exhibited the highest correlation between pyruvate and ASL perfusion, and there were distinct regional patterns of relatively high ASL and low pyruvate normalized rCBF found across subjects. CONCLUSION Acquiring HP 13 C pyruvate metabolic images at higher resolution allows for finer spatial delineation of brain structures and can be used to obtain cerebral perfusion parameters. Pyruvate perfusion parameters were positively correlated to proton ASL perfusion values, indicating a relationship between the two perfusion measures. This HP 13 C study demonstrated that hyperpolarized pyruvate MRI can assess cerebral metabolism and perfusion within the same study.
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Affiliation(s)
- Jasmine Y. Hu
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Sana Vaziri
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
| | - Nikolaj Bøgh
- MR Research Center, Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
| | - Adam W. Autry
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
| | - Robert A. Bok
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Christoffer Laustsen
- MR Research Center, Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Peder E. Z. Larson
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Susan Chang
- Department of Neurological Surgery, University of
California San Francisco, San Francisco, California, USA
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
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Chaumeil M, Guglielmetti C, Qiao K, Tiret B, Ozen M, Krukowski K, Nolan A, Paladini MS, Lopez C, Rosi S. Hyperpolarized 13C metabolic imaging detects long-lasting metabolic alterations following mild repetitive traumatic brain injury. RESEARCH SQUARE 2023:rs.3.rs-3166656. [PMID: 37645937 PMCID: PMC10462249 DOI: 10.21203/rs.3.rs-3166656/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Career athletes, active military, and head trauma victims are at increased risk for mild repetitive traumatic brain injury (rTBI), a condition that contributes to the development of epilepsy and neurodegenerative diseases. Standard clinical imaging fails to identify rTBI-induced lesions, and novel non-invasive methods are needed. Here, we evaluated if hyperpolarized 13C magnetic resonance spectroscopic imaging (HP 13C MRSI) could detect long-lasting changes in brain metabolism 3.5 months post-injury in a rTBI mouse model. Our results show that this metabolic imaging approach can detect changes in cortical metabolism at that timepoint, whereas multimodal MR imaging did not detect any structural or contrast alterations. Using Machine Learning, we further show that HP 13C MRSI parameters can help classify rTBI vs. Sham and predict long-term rTBI-induced behavioral outcomes. Altogether, our study demonstrates the potential of metabolic imaging to improve detection, classification and outcome prediction of previously undetected rTBI.
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Affiliation(s)
| | | | - Kai Qiao
- University of California, San Francisco
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4
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Guglielmetti C, Cordano C, Najac C, Green AJ, Chaumeil MM. Imaging immunomodulatory treatment responses in a multiple sclerosis mouse model using hyperpolarized 13C metabolic MRI. COMMUNICATIONS MEDICINE 2023; 3:71. [PMID: 37217574 DOI: 10.1038/s43856-023-00300-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND In recent years, the ability of conventional magnetic resonance imaging (MRI), including T1 contrast-enhanced (CE) MRI, to monitor high-efficacy therapies and predict long-term disability in multiple sclerosis (MS) has been challenged. Therefore, non-invasive methods to improve MS lesions detection and monitor therapy response are needed. METHODS We studied the combined cuprizone and experimental autoimmune encephalomyelitis (CPZ-EAE) mouse model of MS, which presents inflammatory-mediated demyelinated lesions in the central nervous system as commonly seen in MS patients. Using hyperpolarized 13C MR spectroscopy (MRS) metabolic imaging, we measured cerebral metabolic fluxes in control, CPZ-EAE and CPZ-EAE mice treated with two clinically-relevant therapies, namely fingolimod and dimethyl fumarate. We also acquired conventional T1 CE MRI to detect active lesions, and performed ex vivo measurements of enzyme activities and immunofluorescence analyses of brain tissue. Last, we evaluated associations between imaging and ex vivo parameters. RESULTS We show that hyperpolarized [1-13C]pyruvate conversion to lactate is increased in the brain of untreated CPZ-EAE mice when compared to the control, reflecting immune cell activation. We further demonstrate that this metabolic conversion is significantly decreased in response to the two treatments. This reduction can be explained by increased pyruvate dehydrogenase activity and a decrease in immune cells. Importantly, we show that hyperpolarized 13C MRS detects dimethyl fumarate therapy, whereas conventional T1 CE MRI cannot. CONCLUSIONS In conclusion, hyperpolarized MRS metabolic imaging of [1-13C]pyruvate detects immunological responses to disease-modifying therapies in MS. This technique is complementary to conventional MRI and provides unique information on neuroinflammation and its modulation.
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Affiliation(s)
- Caroline Guglielmetti
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA, USA.
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
| | - Christian Cordano
- Department of Neurology, Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, CA, USA
| | - Chloé Najac
- Department of Radiology, C.J. Gorter MRI Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Ari J Green
- Department of Neurology, Weill Institute for Neurosciences, University of California at San Francisco, San Francisco, CA, USA
- Department of Ophthalmology, University of California at San Francisco, CA, San Francisco, USA
| | - Myriam M Chaumeil
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA, USA.
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
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Fuetterer M, Traechtler J, Busch J, Peereboom SM, Dounas A, Manka R, Weisskopf M, Cesarovic N, Stoeck CT, Kozerke S. Hyperpolarized Metabolic and Parametric CMR Imaging of Longitudinal Metabolic-Structural Changes in Experimental Chronic Infarction. JACC Cardiovasc Imaging 2022; 15:2051-2064. [PMID: 36481073 DOI: 10.1016/j.jcmg.2022.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/10/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Prolonged ischemia and myocardial infarction are followed by a series of dynamic processes that determine the fate of the affected myocardium toward recovery or necrosis. Metabolic adaptions are considered to play a vital role in the recovery of salvageable myocardium in the context of stunned and hibernating myocardium. OBJECTIVES The potential of hyperpolarized pyruvate cardiac magnetic resonance (CMR) alongside functional and parametric CMR as a tool to study the complex metabolic-structural interplay in a longitudinal study of chronic myocardial infarction in an experimental pig model is investigated. METHODS Metabolic imaging using hyperpolarized [1-13C] pyruvate and proton-based CMR including cine, T1/T2 relaxometry, dynamic contrast-enhanced, and late gadolinium enhanced imaging were performed on clinical 3.0-T and 1.5-T MR systems before infarction and at 6 days and 5 and 9 weeks postinfarction in a longitudinal study design. Chronic myocardial infarction in pigs was induced using catheter-based occlusion and compared with healthy controls. RESULTS Metabolic image data revealed temporarily elevated lactate-to-bicarbonate ratios at day 6 in the infarcted relative to remote myocardium. The temporal changes of lactate-to-bicarbonate ratios were found to correlate with changes in T2 and impaired local contractility. Assessment of pyruvate dehydrogenase flux via the hyperpolarized [13C] bicarbonate signal revealed recovery of aerobic cellular respiration in the hibernating myocardium, which correlated with recovery of local radial strain. CONCLUSIONS This study demonstrates the potential of hyperpolarized CMR to longitudinally detect metabolic changes after cardiac infarction over days to weeks. Viable myocardium in the area at risk was identified based on restored pyruvate dehydrogenase flux.
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Affiliation(s)
- Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Julia Traechtler
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Julia Busch
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | | | - Andreas Dounas
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Robert Manka
- Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Miriam Weisskopf
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | - Nikola Cesarovic
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland; Institute of Translational Cardiovascular Technologies, ETH Zurich, Zurich, Switzerland
| | - Christian Torben Stoeck
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland; Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.
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Gamliel A, Shaul D, Gomori JM, Katz‐Brull R. Signal enhancement of hyperpolarized 15 N sites in solution-increase in solid-state polarization at 3.35 T and prolongation of relaxation in deuterated water mixtures. NMR IN BIOMEDICINE 2022; 35:e4787. [PMID: 35704397 PMCID: PMC9787933 DOI: 10.1002/nbm.4787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Hyperpolarized 15 N sites have been found to be promising for generating long-lived hyperpolarized states in solution, and present a promising approach for utilizing dissolution-dynamic nuclear polarization (dDNP)-driven hyperpolarized MRI for imaging in biology and medicine. Specifically, 15 N sites with directly bound protons were shown to be useful when dissolved in D2 O. The purpose of the current study was to further characterize and increase the visibility of such 15 N sites in solutions that mimic an intravenous injection during the first cardiac pass in terms of their H2 O:D2 O composition. The T1 values of hyperpolarized 15 N in [15 N2 ]urea and [15 N]NH4 Cl demonstrated similar dependences on the H2 O:D2 O composition of the solution, with a T1 of about 140 s in 100% D2 O, about twofold shortening in 90% and 80% D2 O, and about threefold shortening in 50% D2 O. [13 C]urea was found to be a useful solid-state 13 C marker for qualitative monitoring of the 15 N polarization process in a commercial pre-clinical dDNP device. Adding trace amounts of Gd3+ to the polarization formulation led to higher solid-state polarization of [13 C]urea and to higher polarization levels of [15 N2 ]urea in solution.
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Affiliation(s)
- Ayelet Gamliel
- Department of Radiology, Hadassah Medical Organization and Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
- The Wohl Institute for Translational MedicineHadassah Medical OrganizationJerusalemIsrael
| | - David Shaul
- Department of Radiology, Hadassah Medical Organization and Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
- The Wohl Institute for Translational MedicineHadassah Medical OrganizationJerusalemIsrael
| | - J. Moshe Gomori
- Department of Radiology, Hadassah Medical Organization and Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
| | - Rachel Katz‐Brull
- Department of Radiology, Hadassah Medical Organization and Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
- The Wohl Institute for Translational MedicineHadassah Medical OrganizationJerusalemIsrael
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7
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Liu X, Tang S, Mu C, Qin H, Cu D, Lai YC, Riselli AM, Delos Santos R, Carvajal L, Gebrezgiabhier D, Bok RA, Chen HY, Flavell RR, Gordon JW, Vigneron DB, Kurhanewicz J, Larson PE. Development of specialized magnetic resonance acquisition techniques for human hyperpolarized [ 13 C, 15 N 2 ]urea + [1- 13 C]pyruvate simultaneous perfusion and metabolic imaging. Magn Reson Med 2022; 88:1039-1054. [PMID: 35526263 PMCID: PMC9810116 DOI: 10.1002/mrm.29266] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE This study aimed to develop and demonstrate the in vivo feasibility of a 3D stack-of-spiral balanced steady-state free precession(3D-bSSFP) urea sequence, interleaved with a metabolite-specific gradient echo (GRE) sequence for pyruvate and metabolic products, for improving the SNR and spatial resolution of the first hyperpolarized 13 C-MRI human study with injection of co-hyperpolarized [1-13 C]pyruvate and [13 C,15 N2 ]urea. METHODS A metabolite-specific bSSFP urea imaging sequence was designed using a urea-specific excitation pulse, optimized TR, and 3D stack-of-spiral readouts. Simulations and phantom studies were performed to validate the spectral response of the sequence. The image quality of urea data acquired by the 3D-bSSFP sequence and the 2D-GRE sequence was evaluated with 2 identical injections of co-hyperpolarized [1-13 C]pyruvate and [13 C,15 N2 ]urea formula in a rat. Subsequently, the feasibility of the acquisition strategy was validated in a prostate cancer patient. RESULTS Simulations and phantom studies demonstrated that 3D-bSSFP sequence achieved urea-only excitation, while minimally perturbing other metabolites (<1%). An animal study demonstrated that compared to GRE, bSSFP sequence provided an ∼2.5-fold improvement in SNR without perturbing urea or pyruvate kinetics, and bSSFP approach with a shorter spiral readout reduced blurring artifacts caused by J-coupling of [13 C,15 N2 ]urea. The human study demonstrated the in vivo feasibility and data quality of the acquisition strategy. CONCLUSION The 3D-bSSFP urea sequence with a stack-of-spiral acquisition demonstrated significantly increased SNR and image quality for [13 C,15 N2 ]urea in co-hyperpolarized [1-13 C]pyruvate and [13 C,15 N2 ]urea imaging studies. This work lays the foundation for future human studies to achieve high-quality and high-SNR metabolism and perfusion images.
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Affiliation(s)
- Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Shuyu Tang
- HeartVista Inc., Los Altos, California, USA
| | - Changhua Mu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Hecong Qin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Di Cu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Ying-Chieh Lai
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
| | - Andrew M. Riselli
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Lucas Carvajal
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Daniel Gebrezgiabhier
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Robert A. Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Robert R. Flavell
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - Peder E.Z. Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
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Abstract
Major advances in biomedical imaging have occurred over the last 2 decades and now allow many physiological, cellular, and molecular processes to be imaged noninvasively in small animal models of cardiovascular disease. Many of these techniques can be also used in humans, providing pathophysiological context and helping to define the clinical relevance of the model. Ultrasound remains the most widely used approach, and dedicated high-frequency systems can obtain extremely detailed images in mice. Likewise, dedicated small animal tomographic systems have been developed for magnetic resonance, positron emission tomography, fluorescence imaging, and computed tomography in mice. In this article, we review the use of ultrasound and positron emission tomography in small animal models, as well as emerging contrast mechanisms in magnetic resonance such as diffusion tensor imaging, hyperpolarized magnetic resonance, chemical exchange saturation transfer imaging, magnetic resonance elastography and strain, arterial spin labeling, and molecular imaging.
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Affiliation(s)
- David E Sosnovik
- Cardiology Division, Cardiovascular Research Center (D.E.S.), Massachusetts General Hospital and Harvard Medical School, Boston.,A.A. Martinos Center for Biomedical Imaging (D.E.S.), Massachusetts General Hospital and Harvard Medical School, Boston.,Harvard-MIT Program in Health Sciences and Technology, Harvard Medical School and Massachusetts Institute of Technology, Cambridge (D.E.S.)
| | - Marielle Scherrer-Crosbie
- Cardiology Division, Hospital of the University of Pennsylvania and Perelman School of Medicine, Philadelphia (M.S.-C)
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Joergensen SH, Hansen ESS, Bøgh N, Bertelsen LB, Staehr PB, Schulte RF, Malloy C, Wiggers H, Laustsen C. Detection of increased pyruvate dehydrogenase flux in the human heart during adenosine stress test using hyperpolarized [1- 13C]pyruvate cardiovascular magnetic resonance imaging. J Cardiovasc Magn Reson 2022; 24:34. [PMID: 35658896 PMCID: PMC9169396 DOI: 10.1186/s12968-022-00860-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Hyperpolarized (HP) [1-13C]pyruvate cardiovascular magnetic resonance (CMR) imaging can visualize the uptake and intracellular conversion of [1-13C]pyruvate to either [1-13C]lactate or 13C-bicarbonate depending on the prevailing metabolic state. The aim of the present study was to combine an adenosine stress test with HP [1-13C]pyruvate CMR to detect cardiac metabolism in the healthy human heart at rest and during moderate stress. METHODS A prospective descriptive study was performed between October 2019 and August 2020. Healthy human subjects underwent cine CMR and HP [1-13C]pyruvate CMR at rest and during adenosine stress. HP [1-13C]pyruvate CMR images were acquired at the mid-left-ventricle (LV) level. Semi-quantitative assessment of first-pass myocardial [1-13C]pyruvate perfusion and metabolism were assessed. Paired t-tests were used to compare mean values at rest and during stress. RESULTS Six healthy subjects (two female), age 29 ± 7 years were studied and no adverse reactions occurred. Myocardial [1-13C]pyruvate perfusion was significantly increased during stress with a reduction in time-to-peak from 6.2 ± 2.8 to 2.7 ± 1.3 s, p = 0.02. This higher perfusion was accompanied by an overall increased myocardial uptake and metabolism. The conversion rate constant (kPL) for lactate increased from 11 ± 9 *10-3 to 20 ± 10 * 10-3 s-1, p = 0.04. The pyruvate oxidation rate (kPB) increased from 4 ± 4 *10-3 to 12 ± 7 *10-3 s-1, p = 0.008. This increase in carbohydrate metabolism was positively correlated with heart rate (R2 = 0.44, p = 0.02). CONCLUSIONS Adenosine stress testing combined with HP [1-13C]pyruvate CMR is feasible and well-tolerated in healthy subjects. We observed an increased pyruvate oxidation during cardiac stress. The present study is an important step in the translation of HP [1-13C]pyruvate CMR into clinical cardiac imaging. Trial registration EUDRACT, 2018-003533-15. Registered 4th of December 2018, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-003533-15.
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Affiliation(s)
- Steen Hylgaard Joergensen
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
- Department of Clinical Medicine, Department of Cardiology, Aarhus University Hospital, Hjoerring, Denmark.
- Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800, Hjoerring, Denmark.
| | - Esben Soevsoe S Hansen
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Nikolaj Bøgh
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Lotte Bonde Bertelsen
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Peter Bisgaard Staehr
- Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800, Hjoerring, Denmark
| | | | - Craig Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, USA
| | - Henrik Wiggers
- Department of Clinical Medicine, Department of Cardiology, Aarhus University Hospital, Hjoerring, Denmark
| | - Christoffer Laustsen
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
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10
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Stewart NJ, Sato T, Takeda N, Hirata H, Matsumoto S. Hyperpolarized 13C Magnetic Resonance Imaging as a Tool for Imaging Tissue Redox State, Oxidative Stress, Inflammation, and Cellular Metabolism. Antioxid Redox Signal 2022; 36:81-94. [PMID: 34218688 PMCID: PMC8792501 DOI: 10.1089/ars.2021.0139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Significance: Magnetic resonance imaging (MRI) with hyperpolarized (HP) 13C-labeled redox-sensitive metabolic tracers can provide noninvasive functional imaging biomarkers, reflecting tissue redox state, oxidative stress, and inflammation, among others. The capability to use endogenous metabolites as 13C-enriched imaging tracers without structural modification makes HP 13C MRI a promising tool to evaluate redox state in patients with various diseases. Recent Advances: Recent studies have demonstrated the feasibility of in vivo metabolic imaging of 13C-labeled tracers polarized by parahydrogen-induced polarization techniques, which offer a cost-effective alternative to the more widely used dissolution dynamic nuclear polarization-based hyperpolarizers. Critical Issues: Although the fluxes of many metabolic pathways reflect the change in tissue redox state, they are not functionally specific. In the present review, we summarize recent challenges in the development of specific 13C metabolic tracers for biomarkers of redox state, including that for detecting reactive oxygen species. Future Directions: Applications of HP 13C metabolic MRI to evaluate redox state have only just begun to be investigated. The possibility to gain a comprehensive understanding of the correlations between tissue redox potential and metabolism under different pathological conditions by using HP 13C MRI is promoting its interest in the clinical arena, along with its noninvasive biomarkers to evaluate the extent of disease and treatment response.
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Affiliation(s)
- Neil J Stewart
- Division of Bioengineering & Bioinformatics, Graduate School of Information Science & Technology, Hokkaido University, Sapporo, Japan.,POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Tatsuyuki Sato
- Division of Cardiology and Metabolism Center for Molecular Medicine, Jichi Medical University, Shimotsuke-shi, Japan.,Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Norihiko Takeda
- Division of Cardiology and Metabolism Center for Molecular Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Hiroshi Hirata
- Division of Bioengineering & Bioinformatics, Graduate School of Information Science & Technology, Hokkaido University, Sapporo, Japan
| | - Shingo Matsumoto
- Division of Bioengineering & Bioinformatics, Graduate School of Information Science & Technology, Hokkaido University, Sapporo, Japan
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11
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Sharma G, Wen X, Maptue NR, Hever T, Malloy CR, Sherry AD, Khemtong C. Co-Polarized [1- 13C]Pyruvate and [1,3- 13C 2]Acetoacetate Provide a Simultaneous View of Cytosolic and Mitochondrial Redox in a Single Experiment. ACS Sens 2021; 6:3967-3977. [PMID: 34761912 DOI: 10.1021/acssensors.1c01225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Cellular redox is intricately linked to energy production and normal cell function. Although the redox states of mitochondria and cytosol are connected by shuttle mechanisms, the redox state of mitochondria may differ from redox in the cytosol in response to stress. However, detecting these differences in functioning tissues is difficult. Here, we employed 13C magnetic resonance spectroscopy (MRS) and co-polarized [1-13C]pyruvate and [1,3-13C2]acetoacetate ([1,3-13C2]AcAc) to monitor production of hyperpolarized (HP) lactate and β-hydroxybutyrate as indicators of cytosolic and mitochondrial redox, respectively. Isolated rat hearts were examined under normoxic conditions, during low-flow ischemia, and after pretreatment with either aminooxyacetate (AOA) or rotenone. All interventions were associated with an increase in [Pi]/[ATP] measured by 31P NMR. In well-oxygenated untreated hearts, rapid conversion of HP [1-13C]pyruvate to [1-13C]lactate and [1,3-13C2]AcAc to [1,3-13C2]β-hydroxybutyrate ([1,3-13C2]β-HB) was readily detected. A significant increase in HP [1,3-13C2]β-HB but not [1-13C]lactate was observed in rotenone-treated and ischemic hearts, consistent with an increase in mitochondrial NADH but not cytosolic NADH. AOA treatments did not alter the productions of HP [1-13C]lactate or [1,3-13C2]β-HB. This study demonstrates that biomarkers of mitochondrial and cytosolic redox may be detected simultaneously in functioning tissues using co-polarized [1-13C]pyruvate and [1,3-13C2]AcAc and 13C MRS and that changes in mitochondrial redox may precede changes in cytosolic redox.
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Affiliation(s)
- Gaurav Sharma
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Xiaodong Wen
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Nesmine R. Maptue
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Thomas Hever
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - Craig R. Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
| | - A. Dean Sherry
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Department of Chemistry, University of Texas at Dallas, Richardson, Texas 75080, United States
| | - Chalermchai Khemtong
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, Florida 32610, United States
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, Florida 32610, United States
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12
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Jørgensen SH, Bøgh N, Hansen E, Væggemose M, Wiggers H, Laustsen C. Hyperpolarized MRI - An update and future perspectives. Semin Nucl Med 2021; 52:374-381. [PMID: 34785033 DOI: 10.1053/j.semnuclmed.2021.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 11/11/2022]
Abstract
In recent years, hyperpolarized 13C magnetic resonance spectroscopic (MRS) imaging has emerged as a complementary metabolic imaging approach. Hyperpolarization via dissolution dynamic nuclear polarization is a technique that enhances the MR signal of 13C-enriched molecules by a factor of > 104, enabling detection downstream metabolites in a variety of intracellular metabolic pathways. The aim of the present review is to provide the reader with an update on hyperpolarized 13C MRS imaging and to assess the future clinical potential of the technology. Several carbon-based probes have been used in hyperpolarized studies. However, the first and most widely used 13C-probe in clinical studies is [1-13C]pyruvate. In this probe, the enrichment of 13C is performed at the first carbon position as the only modification. Hyperpolarized [1-13C]pyruvate MRS imaging can detect intracellular production of [1-13C]lactate and 13C-bicarbonate non-invasively and in real time without the use of ionizing radiation. Thus, by probing the balance between oxidative and glycolytic metabolism, hyperpolarized [1-13C]pyruvate MRS imaging can image the Warburg effect in malignant tumors and detect the hallmarks of ischemia or viability in the myocardium. An increasing number of clinical studies have demonstrated that clinical hyperpolarized 13C MRS imaging is not only possible, but also it provides metabolic information that was previously inaccessible by non-invasive techniques. Although the technology is still in its infancy and several technical improvements are warranted, it is of paramount importance that nuclear medicine physicians gain knowledge of the possibilities and pitfalls of the technique. Hyperpolarized 13C MRS imaging may become an integrated feature in combined metabolic imaging of the future.
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Affiliation(s)
- S H Jørgensen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; The Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark; The Department of Cardiology, North Denmark Regional Hospital, Hjørring, Denmark
| | - N Bøgh
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ess Hansen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - M Væggemose
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; GE Healthcare, Brøndby, Denmark
| | - H Wiggers
- The Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
| | - C Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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13
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Qin H, Tang S, Riselli AM, Bok RA, Delos Santos R, van Criekinge M, Gordon JW, Aggarwal R, Chen R, Goddard G, Zhang CT, Chen A, Reed G, Ruscitto DM, Slater J, Sriram R, Larson PEZ, Vigneron DB, Kurhanewicz J. Clinical translation of hyperpolarized 13 C pyruvate and urea MRI for simultaneous metabolic and perfusion imaging. Magn Reson Med 2021; 87:138-149. [PMID: 34374471 PMCID: PMC8616838 DOI: 10.1002/mrm.28965] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/30/2021] [Accepted: 07/23/2021] [Indexed: 11/11/2022]
Abstract
Purpose The combined hyperpolarized (HP) 13C pyruvate and urea MRI has provided a simultaneous assessment of glycolytic metabolism and tissue perfusion for improved cancer diagnosis and therapeutic evaluation in preclinical studies. This work aims to translate this dual‐probe HP imaging technique to clinical research. Methods A co‐polarization system was developed where [1‐13C]pyruvic acid (PA) and [13C, 15N2]urea in water solution were homogeneously mixed and polarized on a 5T SPINlab system. Physical and chemical characterizations and toxicology studies of the combined probe were performed. Simultaneous metabolic and perfusion imaging was performed on a 3T clinical MR scanner by alternatively applying a multi‐slice 2D spiral sequence for [1‐13C]pyruvate and its downstream metabolites and a 3D balanced steady‐state free precession (bSSFP) sequence for [13C, 15N2]urea. Results The combined PA/urea probe has a glass‐formation ability similar to neat PA and can generate nearly 40% liquid‐state 13C polarization for both pyruvate and urea in 3‐4 h. A standard operating procedure for routine on‐site production was developed and validated to produce 40 mL injection product of approximately 150 mM pyruvate and 35 mM urea. The toxicology study demonstrated the safety profile of the combined probe. Dynamic metabolite‐specific imaging of [1‐13C]pyruvate, [1‐13C]lactate, [1‐13C]alanine, and [13C, 15N2]urea was achieved with adequate spatial (2.6 mm × 2.6 mm) and temporal resolution (4.2 s), and urea images showed reduced off‐resonance artifacts due to the JCN coupling. Conclusion The reported technical development and translational studies will lead to the first‐in‐human dual‐agent HP MRI study and mark the clinical translation of the first HP 13C MRI probe after pyruvate.
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Affiliation(s)
- Hecong Qin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Andrew M Riselli
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Mark van Criekinge
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Rahul Aggarwal
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Rui Chen
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | | | | | - Albert Chen
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | - Galen Reed
- General Electric Healthcare, Milwaukee, Wisconsin, USA
| | | | - James Slater
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, California, USA
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14
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Larson PEZ, Gordon JW. Hyperpolarized Metabolic MRI-Acquisition, Reconstruction, and Analysis Methods. Metabolites 2021; 11:386. [PMID: 34198574 PMCID: PMC8231874 DOI: 10.3390/metabo11060386] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 01/05/2023] Open
Abstract
Hyperpolarized metabolic MRI with 13C-labeled agents has emerged as a powerful technique for in vivo assessments of real-time metabolism that can be used across scales of cells, tissue slices, animal models, and human subjects. Hyperpolarized contrast agents have unique properties compared to conventional MRI scanning and MRI contrast agents that require specialized imaging methods. Hyperpolarized contrast agents have a limited amount of available signal, irreversible decay back to thermal equilibrium, bolus injection and perfusion kinetics, cellular uptake and metabolic conversion kinetics, and frequency shifts between metabolites. This article describes state-of-the-art methods for hyperpolarized metabolic MRI, summarizing data acquisition, reconstruction, and analysis methods in order to guide the design and execution of studies.
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Affiliation(s)
- Peder Eric Zufall Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USA;
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco, CA 94143, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley, CA 94143, USA
| | - Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USA;
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15
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Crane JC, Gordon JW, Chen HY, Autry AW, Li Y, Olson MP, Kurhanewicz J, Vigneron DB, Larson PEZ, Xu D. Hyperpolarized 13 C MRI data acquisition and analysis in prostate and brain at University of California, San Francisco. NMR IN BIOMEDICINE 2021; 34:e4280. [PMID: 32189442 PMCID: PMC7501204 DOI: 10.1002/nbm.4280] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 01/24/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
Based on the expanding set of applications for hyperpolarized carbon-13 (HP-13 C) MRI, this work aims to communicate standardized methodology implemented at the University of California, San Francisco, as a primer for conducting reproducible metabolic imaging studies of the prostate and brain. Current state-of-the-art HP-13 C acquisition, data processing/reconstruction and kinetic modeling approaches utilized in patient studies are presented together with the rationale underpinning their usage. Organized around spectroscopic and imaging-based methods, this guide provides an extensible framework for handling a variety of HP-13 C applications, which derives from two examples with dynamic acquisitions: 3D echo-planar spectroscopic imaging of the human prostate and frequency-specific 2D multislice echo-planar imaging of the human brain. Details of sequence-specific parameters and processing techniques contained in these examples should enable investigators to effectively tailor studies around individual-use cases. Given the importance of clinical integration in improving the utility of HP exams, practical aspects of standardizing data formats for reconstruction, analysis and visualization are also addressed alongside open-source software packages that enhance institutional interoperability and validation of methodology. To facilitate the adoption and further development of this methodology, example datasets and analysis pipelines have been made available in the supporting information.
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Affiliation(s)
- Jason C Crane
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Marram P Olson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
- Department of Pharmaceutical Chemistry, University of California, San Francisco, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
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16
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Shaul D, Azar A, Sapir G, Uppala S, Nardi-Schreiber A, Gamliel A, Sosna J, Gomori JM, Katz-Brull R. Correlation between lactate dehydrogenase/pyruvate dehydrogenase activities ratio and tissue pH in the perfused mouse heart: A potential noninvasive indicator of cardiac pH provided by hyperpolarized magnetic resonance. NMR IN BIOMEDICINE 2021; 34:e4444. [PMID: 33258527 DOI: 10.1002/nbm.4444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 10/05/2020] [Accepted: 10/24/2020] [Indexed: 06/12/2023]
Abstract
Cardiovascular diseases account for more than 30% of all deaths worldwide and many could be ameliorated with early diagnosis. Current cardiac imaging modalities can assess blood flow, heart anatomy and mechanical function. However, for early diagnosis and improved treatment, further functional biomarkers are needed. One such functional biomarker could be the myocardium pH. Although tissue pH is already determinable via MR techniques, and has been since the early 1990s, it remains elusive to use practically. The objective of this study was to explore the possibility to evaluate cardiac pH noninvasively, using in-cell enzymatic rates of hyperpolarized [1-13 C]pyruvate metabolism (ie, moles of product produced per unit time) determined directly in real time using magnetic resonance spectroscopy in a perfused mouse heart model. As a gold standard for tissue pH we used 31 P spectroscopy and the chemical shift of the inorganic phosphate (Pi) signal. The nonhomogenous pH distribution of the perfused heart was analyzed using a multi-parametric analysis of this signal, thus taking into account the heterogeneous nature of this characteristic. As opposed to the signal ratio of hyperpolarized [13 C]bicarbonate to [13 CO2 ], which has shown correlation to pH in other studies, we investigated here the ratio of two intracellular enzymatic rates: lactate dehydrogenase (LDH) and pyruvate dehydrogenase (PDH), by way of determining the production rates of [1-13 C]lactate and [13 C]bicarbonate, respectively. The enzyme activities determined here are intracellular, while the pH determined using the Pi signal may contain an extracellular component, which could not be ruled out. Nevertheless, we report a strong correlation between the tissue pH and the LDH/PDH activities ratio. This work may pave the way for using the LDH/PDH activities ratio as an indicator of cardiac intracellular pH in vivo, in an MRI examination.
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Affiliation(s)
- David Shaul
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Assad Azar
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Gal Sapir
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Sivaranjan Uppala
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Atara Nardi-Schreiber
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Ayelet Gamliel
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Jacob Sosna
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - J Moshe Gomori
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Rachel Katz-Brull
- Department of Radiology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
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17
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Abstract
Current cardiovascular magnetic resonance imaging techniques provide an exquisite assessment of the structure and function of the heart and great vessels, but their ability to assess the molecular processes that underpin changes in cardiac function in health and disease is limited by inherent insensitivity. Hyperpolarized magnetic resonance is a new technology which overcomes this limitation, generating molecular contrast agents with an improvement in magnetic resonance signal of up to five orders of magnitude. One key molecule, hyperpolarized [1-13C]pyruvate, shows particular promise for the assessment of cardiac energy metabolism and other fundamental biological processes in cardiovascular disease. This molecule has numerous potential applications of clinical relevance and has now been translated to human use in early clinical studies. This review outlines the principles of hyperpolarized magnetic resonance and key potential cardiovascular applications for this new technology. Finally, we provide an overview of the pipeline for forthcoming hyperpolarized agents and their potential applications in cardiovascular disease.
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18
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Mariager CØ, Hansen ESS, Bech SK, Munk A, Kjaergaard U, Lyhne MD, Søberg K, Nielsen PF, Ringgaard S, Laustsen C. Graft assessment of the ex vivo perfused porcine kidney using hyperpolarized [1- 13 C]pyruvate. Magn Reson Med 2020; 84:2645-2655. [PMID: 32557782 DOI: 10.1002/mrm.28363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 05/07/2020] [Accepted: 05/21/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE Normothermic perfusion is an emerging strategy for donor organ preservation and therapy, incited by the high worldwide demand for organs for transplantation. Hyperpolarized MRI and MRS using [1-13 C]pyruvate and other 13 C-labeled molecules pose a novel way to acquire highly detailed information about metabolism and function in a noninvasive manner. This study investigates the use of this methodology as a means to study and monitor the state of ex vivo perfused porcine kidneys, in the context of kidney graft preservation research. METHODS Kidneys from four 40-kg Danish domestic pigs were perfused ex vivo with whole blood under normothermic conditions, using an MR-compatible perfusion system. Kidneys were investigated using 1 H MRI as well as hyperpolarized [1-13 C]pyruvate MRI and MRS. Using the acquired anatomical, functional and metabolic data, the state of the ex vivo perfused porcine kidney could be quantified. RESULTS Four kidneys were successfully perfused for 120 minutes and verified using a DCE perfusion experiment. Renal metabolism was examined using hyperpolarized [1-13 C]pyruvate MRI and MRS, and displayed an apparent reduction in pyruvate turnover compared with the usual case in vivo. Perfusion and blood gas parameters were in the normal ex vivo range. CONCLUSION This study demonstrates the ability to monitor ex vivo graft metabolism and function in a large animal model, resembling human renal physiology. The ability of hyperpolarized MRI and MRS to directly compare the metabolic state of an organ in vivo and ex vivo, in combination with the simple MR implementation of normothermic perfusion, renders this methodology a powerful future tool for graft preservation research.
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Affiliation(s)
| | | | - Sabrina Kahina Bech
- Department of Clinical Medicine, The MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Anders Munk
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Uffe Kjaergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mads Dam Lyhne
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Karsten Søberg
- Department of Anesthesia and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Fast Nielsen
- Department of Anesthesia and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Steffen Ringgaard
- Department of Clinical Medicine, The MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- Department of Clinical Medicine, The MR Research Centre, Aarhus University, Aarhus, Denmark
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19
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Park I, Lupo JM, Nelson SJ. Correlation of Tumor Perfusion Between Carbon-13 Imaging with Hyperpolarized Pyruvate and Dynamic Susceptibility Contrast MRI in Pre-Clinical Model of Glioblastoma. Mol Imaging Biol 2020; 21:626-632. [PMID: 30225760 DOI: 10.1007/s11307-018-1275-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to compare C-13 imaging parameters with hyperpolarized [1-13C]pyruvate with conventional gadolinium (Gd)-based perfusion weighted imaging using an orthotopic xenograft model of human glioblastoma multiforme (GBM). PROCEDURES C-13 3D magnetic resonance spectroscopic imaging (MRSI) data were obtained from 14 tumor-bearing rats after the injection of hyperpolarized [1-13C]pyruvate at a 3T scanner. Dynamic susceptibility contrast (DSC) perfusion-weighted MR images were obtained following intravenous administration of Gd-DTPA. Normalized lactate, pyruvate, total carbon, and lactate to pyruvate ratio from C-13 MRSI data were compared with normalized peak height and percent recovery of ΔR2* curve from the DSC images in the voxels containing tumor using a Pearson's linear correlation. RESULTS Normalized peak height from DSC imaging showed substantial correlations with normalized lactate (r = 0.6, p = 0.02) and total carbon (r = 0.6, p = 0.02) from hyperpolarized C-13 MRSI data. CONCLUSIONS Since the peak height in the ΔR2* curve from DSC data is related to the extent of blood volume, these hyperpolarized C-13 imaging parameters may be used to assess blood volume in rodent intracranial xenograft models of GBM.
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Affiliation(s)
- Ilwoo Park
- Department of Radiology, Chonnam National University Medical School, Jeabongro 42, Donggu, Gwangju, 61469, South Korea. .,Department of Radiology, Chonnam National University Hospital, Gwangju, South Korea.
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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20
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Topping GJ, Hundshammer C, Nagel L, Grashei M, Aigner M, Skinner JG, Schulte RF, Schilling F. Acquisition strategies for spatially resolved magnetic resonance detection of hyperpolarized nuclei. MAGMA (NEW YORK, N.Y.) 2020; 33:221-256. [PMID: 31811491 PMCID: PMC7109201 DOI: 10.1007/s10334-019-00807-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/08/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022]
Abstract
Hyperpolarization is an emerging method in magnetic resonance imaging that allows nuclear spin polarization of gases or liquids to be temporarily enhanced by up to five or six orders of magnitude at clinically relevant field strengths and administered at high concentration to a subject at the time of measurement. This transient gain in signal has enabled the non-invasive detection and imaging of gas ventilation and diffusion in the lungs, perfusion in blood vessels and tissues, and metabolic conversion in cells, animals, and patients. The rapid development of this method is based on advances in polarizer technology, the availability of suitable probe isotopes and molecules, improved MRI hardware and pulse sequence development. Acquisition strategies for hyperpolarized nuclei are not yet standardized and are set up individually at most sites depending on the specific requirements of the probe, the object of interest, and the MRI hardware. This review provides a detailed introduction to spatially resolved detection of hyperpolarized nuclei and summarizes novel and previously established acquisition strategies for different key areas of application.
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Affiliation(s)
- Geoffrey J Topping
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christian Hundshammer
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Luca Nagel
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martin Grashei
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maximilian Aigner
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jason G Skinner
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | - Franz Schilling
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
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21
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Gordon JW, Chen HY, Dwork N, Tang S, Larson PEZ. Fast Imaging for Hyperpolarized MR Metabolic Imaging. J Magn Reson Imaging 2020; 53:686-702. [PMID: 32039520 DOI: 10.1002/jmri.27070] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 12/14/2022] Open
Abstract
MRI with hyperpolarized carbon-13 agents has created a new type of noninvasive, in vivo metabolic imaging that can be applied in cell, animal, and human studies. The use of 13 C-labeled agents, primarily [1-13 C]pyruvate, enables monitoring of key metabolic pathways with the ability to image substrate and products based on their chemical shift. Over 10 sites worldwide are now performing human studies with this new approach for studies of cancer, heart disease, liver disease, and kidney disease. Hyperpolarized metabolic imaging studies must be performed within several minutes following creation of the hyperpolarized agent due to irreversible decay of the net magnetization back to equilibrium, so fast imaging methods are critical. The imaging methods must include multiple metabolites, separated based on their chemical shift, which are also undergoing rapid metabolic conversion (via label exchange), further exacerbating the challenges of fast imaging. This review describes the state-of-the-art in fast imaging methods for hyperpolarized metabolic imaging. This includes the approach and tradeoffs between three major categories of fast imaging methods-fast spectroscopic imaging, model-based strategies, and metabolite specific imaging-as well additional options of parallel imaging, compressed sensing, tailored RF flip angles, refocused imaging methods, and calibration methods that can improve the scan coverage, speed, signal-to-noise ratio (SNR), resolution, and/or robustness of these studies. To date, these approaches have produced extremely promising initial human imaging results. Improvements to fast hyperpolarized metabolic imaging methods will provide better coverage, SNR, resolution, and reproducibility for future human imaging studies. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Nicholas Dwork
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA.,UC Berkeley/UCSF Graduate Program in Bioengineering, Berkeley, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA.,UC Berkeley/UCSF Graduate Program in Bioengineering, Berkeley, California, USA
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22
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Barton GP, Macdonald EB, Goss KN, Eldridge MW, Fain SB. Measuring the link between cardiac mechanical function and metabolism during hyperpolarized 13C-pyruvate magnetic resonance experiments. Magn Reson Imaging 2020; 68:9-17. [PMID: 31978518 DOI: 10.1016/j.mri.2020.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/19/2019] [Accepted: 01/19/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE The goal of this study was to develop a methodology to investigate the relationship between contractile function and hyperpolarized (HP) [1-13C]pyruvate metabolism in a small animal model. To achieve sufficient signal from HP 13C compounds, HP 13C MRS/MRSI has required relatively large infusion volumes relative to the total blood volume in small animal models, which may affect cardiac function. METHODS Eight female Sprague Dawley rats were imaged on a 4.7T scanner with a dual tuned 1H/13C volume coil. ECG and respiratory gated k-t spiral MRSI and an IDEAL based reconstruction to determine [1-13C]pyruvate metabolism in the myocardium. This was coupled with 1H cine MRI to determine ventricular volumes and mechanical function pre- and post-infusion of [1-13C]pyruvate. For comparison to the [1-13C]pyruvate experiments, three female Sprague Dawley rats were imaged with 1H cine MRI to determine myocardial function pre- and post-saline infusion. RESULTS We demonstrated significant changes in cardiac contractile function between pre- and post-infusion of [1-13C]pyruvate. Specifically, there was an increase in end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF). Additionally, the ventricular vascular coupling ratio (VVCR) showed an improvement after [1-13C]pyruvate infusion, indicating increased systolic performance due to an increased arterial load. There was a moderate to strong relationship between the downstream metabolic conversion of pyruvate to bicarbonate and a strong relationship between the conversion of pyruvate to lactate and the cardiac mechanical function response. CONCLUSION The infusion of [1-13C]pyruvate resulted in demonstrable increases in contractile function which was related to pyruvate conversion to bicarbonate and lactate. The combined effects of the infusion volume and inotropic effects of pyruvate metabolism likely explains the augmentation in myocardial mechanical function seen in these experiments. Given the relationship between pyruvate metabolism and contractile function observed in this study, this methodological approach may be utilized to better understand cardiac metabolic and functional remodeling in heart disease.
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Affiliation(s)
| | | | - Kara N Goss
- Medicine University of Wisconsin, Madison, WI, USA; Pediatrics University of Wisconsin, Madison, WI, USA
| | - Marlowe W Eldridge
- Pediatrics University of Wisconsin, Madison, WI, USA; Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| | - Sean B Fain
- Medical Physics, University of Wisconsin, Madison, WI, USA; Biomedical Engineering, University of Wisconsin, Madison, WI, USA; Radiology, University of Wisconsin, Madison, WI, USA.
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23
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Stewart NJ, Matsumoto S. Biomedical Applications of the Dynamic Nuclear Polarization and Parahydrogen Induced Polarization Techniques for Hyperpolarized 13C MR Imaging. Magn Reson Med Sci 2019; 20:1-17. [PMID: 31902907 PMCID: PMC7952198 DOI: 10.2463/mrms.rev.2019-0094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Since the first pioneering report of hyperpolarized [1-13C]pyruvate magnetic resonance imaging (MRI) of the Warburg effect in prostate cancer patients, clinical dissemination of the technique has been rapid; close to 10 sites worldwide now possess a polarizer fit for the clinic, and more than 30 clinical trials, predominantly for oncological applications, are already registered on the US and European clinical trials databases. Hyperpolarized 13C probes to study pathophysiological processes beyond the Warburg effect, including tricarboxylic acid cycle metabolism, intra-cellular pH and cellular necrosis have also been demonstrated in the preclinical arena and are pending clinical translation, and the simultaneous injection of multiple co-polarized agents is opening the door to high-sensitivity, multi-functional molecular MRI with a single dose. Here, we review the biomedical applications to date of the two polarization methods that have been used for in vivo hyperpolarized 13C molecular MRI; namely, dissolution dynamic nuclear polarization and parahydrogen-induced polarization. The basic concept of hyperpolarization and the fundamental theory underpinning these two key 13C hyperpolarization methods, along with recent technological advances that have facilitated biomedical realization, are also covered.
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Affiliation(s)
- Neil J Stewart
- Division of Bioengineering and Bioinformatics, Graduate School of Information Science and Technology, Hokkaido University
| | - Shingo Matsumoto
- Division of Bioengineering and Bioinformatics, Graduate School of Information Science and Technology, Hokkaido University
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Le Page LM, Guglielmetti C, Najac CF, Tiret B, Chaumeil MM. Hyperpolarized 13 C magnetic resonance spectroscopy detects toxin-induced neuroinflammation in mice. NMR IN BIOMEDICINE 2019; 32:e4164. [PMID: 31437326 PMCID: PMC6817388 DOI: 10.1002/nbm.4164] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/27/2019] [Accepted: 07/15/2019] [Indexed: 05/04/2023]
Abstract
Lipopolysaccharide (LPS) is a commonly used agent for induction of neuroinflammation in preclinical studies. Upon injection, LPS causes activation of microglia and astrocytes, whose metabolism alters to favor glycolysis. Assessing in vivo neuroinflammation and its modulation following therapy remains challenging, and new noninvasive methods allowing for longitudinal monitoring would be highly valuable. Hyperpolarized (HP) 13 C magnetic resonance spectroscopy (MRS) is a promising technique for assessing in vivo metabolism. In addition to applications in oncology, the most commonly used probe of [1-13 C] pyruvate has shown potential in assessing neuroinflammation-linked metabolism in mouse models of multiple sclerosis and traumatic brain injury. Here, we aimed to investigate LPS-induced neuroinflammatory changes using HP [1-13 C] pyruvate and HP 13 C urea. 2D chemical shift imaging following simultaneous intravenous injection of HP [1-13 C] pyruvate and HP 13 C urea was performed at baseline (day 0) and at days 3 and 7 post-intracranial injection of LPS (n = 6) or saline (n = 5). Immunofluorescence (IF) analyses were performed for Iba1 (resting and activated microglia/macrophages), GFAP (resting and reactive astrocytes) and CD68 (activated microglia/macrophages). A significant increase in HP [1-13 C] lactate production was observed at days 3 and 7 following injection, in the injected (ipsilateral) side of the LPS-treated mouse brain, but not in either the contralateral side or saline-injected animals. HP 13 C lactate/pyruvate ratio, without and with normalization to urea, was also significantly increased in the ipsilateral LPS-injected brain at 7 days compared with baseline. IF analyses showed a significant increase in CD68 and GFAP staining at 3 days, followed by increased numbers of Iba1 and GFAP positive cells at 7 days post-LPS injection. In conclusion, we can detect LPS-induced changes in the mouse brain using HP 13 C MRS, in alignment with increased numbers of microglia/macrophages and astrocytes. This study demonstrates that HP 13 C spectroscopy has substantial potential for providing noninvasive information on neuroinflammation.
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Affiliation(s)
- Lydia M Le Page
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Caroline Guglielmetti
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Chloé F Najac
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Brice Tiret
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Myriam M Chaumeil
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
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25
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Siddiqui S, Habertheuer A, Xin Y, Pourfathi M, Tao JQ, Hamedani H, Kadlecek S, Duncan I, Vallabhajosyula P, Naji A, Chatterjee S, Rizi R. Detection of lung transplant rejection in a rat model using hyperpolarized [1- 13 C] pyruvate-based metabolic imaging. NMR IN BIOMEDICINE 2019; 32:e4107. [PMID: 31112351 PMCID: PMC6620127 DOI: 10.1002/nbm.4107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/19/2019] [Accepted: 03/29/2019] [Indexed: 05/03/2023]
Abstract
The current standard for noninvasive imaging of acute rejection consists of X-ray/CT, which derive their contrast from changes in ventilation, inflammation and edema, as well as remodeling during rejection. We propose the use of hyperpolarized [1-13 C] pyruvate MRI-which provides real-time metabolic assessment of tissue-as an early biomarker for tissue rejection. In this preliminary study, we used μCT-derived parameters and HP 13 C MR-derived biomarkers to predict rejection in an orthotopic left lung transplant model in both allogeneic and syngeneic rats. On day 3, the normalized lung density-a parameter that accounts for both lung volume (mL) and density (HU)-was -0.335 (CI: -0.598, -0.073) and - 0.473 (CI: -0.726, -0.220) for the allograft and isograft, respectively (not significant, 0.40). The lactate-to-pyruvate ratios-derived from the HP 13 C MRI-for the allograft and isograft were 0.200 (CI: 0.161, 0.240) and 0.114 (CI: 0.074, 0.153), respectively (significant, 0.020). Both techniques showed tissue rejection on day 7. A separate sub-study revealed CD8+ cells as the primary source of the lactate-to-pyruvate signal. Our study suggests that hyperpolarized (HP) [1-13 C] pyruvate MRI is a promising early biomarker for tissue rejection that provides metabolic assessment in real time based on changes in cellularity and metabolism of lung tissue and the infiltrating inflammatory cells, and may be able to predict tissue rejection earlier than X-ray/CT.
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Affiliation(s)
- Sarmad Siddiqui
- Department of Radiology, University of Pennsylvania, PA, USA
| | | | - Yi Xin
- Department of Radiology, University of Pennsylvania, PA, USA
| | | | - Jian-quin Tao
- Institute for Environmental Medicine, University of Pennsylvania, PA, USA
| | - Hooman Hamedani
- Department of Radiology, University of Pennsylvania, PA, USA
| | | | - Ian Duncan
- Department of Radiology, University of Pennsylvania, PA, USA
| | | | - Ali Naji
- Department of Surgery, University of Pennsylvania, PA, USA
| | - Shampa Chatterjee
- Institute for Environmental Medicine, University of Pennsylvania, PA, USA
| | - Rahim Rizi
- Department of Radiology, University of Pennsylvania, PA, USA
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Wang ZJ, Ohliger MA, Larson PEZ, Gordon JW, Bok RA, Slater J, Villanueva-Meyer JE, Hess CP, Kurhanewicz J, Vigneron DB. Hyperpolarized 13C MRI: State of the Art and Future Directions. Radiology 2019; 291:273-284. [PMID: 30835184 DOI: 10.1148/radiol.2019182391] [Citation(s) in RCA: 184] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hyperpolarized (HP) carbon 13 (13C) MRI is an emerging molecular imaging method that allows rapid, noninvasive, and pathway-specific investigation of dynamic metabolic and physiologic processes that were previously inaccessible to imaging. This technique has enabled real-time in vivo investigations of metabolism that are central to a variety of diseases, including cancer, cardiovascular disease, and metabolic diseases of the liver and kidney. This review provides an overview of the methods of hyperpolarization and 13C probes investigated to date in preclinical models of disease. The article then discusses the progress that has been made in translating this technology for clinical investigation. In particular, the potential roles and emerging clinical applications of HP [1-13C]pyruvate MRI will be highlighted. The future directions to enable the adoption of this technology to advance the basic understanding of metabolism, to improve disease diagnosis, and to accelerate treatment assessment are also detailed.
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Affiliation(s)
- Zhen J Wang
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - Michael A Ohliger
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - Peder E Z Larson
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - Jeremy W Gordon
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - Robert A Bok
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - James Slater
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - Javier E Villanueva-Meyer
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - Christopher P Hess
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - John Kurhanewicz
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
| | - Daniel B Vigneron
- From the Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143
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Kurhanewicz J, Vigneron DB, Ardenkjaer-Larsen JH, Bankson JA, Brindle K, Cunningham CH, Gallagher FA, Keshari KR, Kjaer A, Laustsen C, Mankoff DA, Merritt ME, Nelson SJ, Pauly JM, Lee P, Ronen S, Tyler DJ, Rajan SS, Spielman DM, Wald L, Zhang X, Malloy CR, Rizi R. Hyperpolarized 13C MRI: Path to Clinical Translation in Oncology. Neoplasia 2019; 21:1-16. [PMID: 30472500 PMCID: PMC6260457 DOI: 10.1016/j.neo.2018.09.006] [Citation(s) in RCA: 280] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 12/22/2022]
Abstract
This white paper discusses prospects for advancing hyperpolarization technology to better understand cancer metabolism, identify current obstacles to HP (hyperpolarized) 13C magnetic resonance imaging's (MRI's) widespread clinical use, and provide recommendations for overcoming them. Since the publication of the first NIH white paper on hyperpolarized 13C MRI in 2011, preclinical studies involving [1-13C]pyruvate as well a number of other 13C labeled metabolic substrates have demonstrated this technology's capacity to provide unique metabolic information. A dose-ranging study of HP [1-13C]pyruvate in patients with prostate cancer established safety and feasibility of this technique. Additional studies are ongoing in prostate, brain, breast, liver, cervical, and ovarian cancer. Technology for generating and delivering hyperpolarized agents has evolved, and new MR data acquisition sequences and improved MRI hardware have been developed. It will be important to continue investigation and development of existing and new probes in animal models. Improved polarization technology, efficient radiofrequency coils, and reliable pulse sequences are all important objectives to enable exploration of the technology in healthy control subjects and patient populations. It will be critical to determine how HP 13C MRI might fill existing needs in current clinical research and practice, and complement existing metabolic imaging modalities. Financial sponsorship and integration of academia, industry, and government efforts will be important factors in translating the technology for clinical research in oncology. This white paper is intended to provide recommendations with this goal in mind.
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Affiliation(s)
- John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | | | - James A Bankson
- Department of Imaging Physics, MD Anderson Medical Center, Houston, TX, USA
| | - Kevin Brindle
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | | | | | - Kayvan R Keshari
- Department of Radiology, Memorial Sloan Kettering Cancer Center, NY, New York, USA
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Denmark
| | | | - David A Mankoff
- Department of Radiology, University of Pennsylvania, PA, USA
| | - Matthew E Merritt
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, USA
| | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | - John M Pauly
- Department of Electric Engineering, Stanford University, USA
| | - Philips Lee
- Functional Metabolism Group, Singapore Biomedical Consortium, Agency for Science, Technology and Research, Singapore
| | - Sabrina Ronen
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | - Damian J Tyler
- Department of Biomedical Science, University of Oxford, Oxford, UK
| | - Sunder S Rajan
- Center for Devices and Radiological Health (CDRH), FDA, White Oak, MD, USA
| | - Daniel M Spielman
- Departments of Radiology and Electric Engineering, Stanford University, USA
| | - Lawrence Wald
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Xiaoliang Zhang
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | - Craig R Malloy
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Rahim Rizi
- Department of Radiology, University of Pennsylvania, PA, USA
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Fuetterer M, Busch J, Traechtler J, Wespi P, Peereboom SM, Sauer M, Lipiski M, Fleischmann T, Cesarovic N, Stoeck CT, Kozerke S. Quantitative myocardial first-pass cardiovascular magnetic resonance perfusion imaging using hyperpolarized [1- 13C] pyruvate. J Cardiovasc Magn Reson 2018; 20:73. [PMID: 30415642 PMCID: PMC6231262 DOI: 10.1186/s12968-018-0495-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 10/09/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The feasibility of absolute myocardial blood flow quantification and suitability of hyperpolarized [1-13C] pyruvate as contrast agent for first-pass cardiovascular magnetic resonance (CMR) perfusion measurements are investigated with simulations and demonstrated in vivo in a swine model. METHODS A versatile simulation framework for hyperpolarized CMR subject to physical, physiological and technical constraints was developed and applied to investigate experimental conditions for accurate perfusion CMR with hyperpolarized [1-13C] pyruvate. Absolute and semi-quantitative perfusion indices were analyzed with respect to experimental parameter variations and different signal-to-noise ratio (SNR) levels. Absolute myocardial blood flow quantification was implemented with an iterative deconvolution approach based on Fermi functions. To demonstrate in vivo feasibility, velocity-selective excitation with an echo-planar imaging readout was used to acquire dynamic myocardial stress perfusion images in four healthy swine. Arterial input functions were extracted from an additional image slice with conventional excitation that was acquired within the same heartbeat. RESULTS Simulations suggest that obtainable SNR and B0 inhomogeneity in vivo are sufficient for the determination of absolute and semi-quantitative perfusion with ≤25% error. It is shown that for expected metabolic conversion rates, metabolic conversion of pyruvate can be neglected over the short duration of acquisition in first-pass perfusion CMR. In vivo measurements suggest that absolute myocardial blood flow quantification using hyperpolarized [1-13C] pyruvate is feasible with an intra-myocardial variability comparable to semi-quantitative perfusion indices. CONCLUSION The feasibility of quantitative hyperpolarized first-pass perfusion CMR using [1-13C] pyruvate has been investigated in simulations and demonstrated in swine. Using an approved and metabolically active compound is envisioned to increase the value of hyperpolarized perfusion CMR in patients.
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Affiliation(s)
- Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse, 35 8092 Zurich, Switzerland
| | - Julia Busch
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse, 35 8092 Zurich, Switzerland
| | - Julia Traechtler
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse, 35 8092 Zurich, Switzerland
| | - Patrick Wespi
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse, 35 8092 Zurich, Switzerland
| | - Sophie M. Peereboom
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse, 35 8092 Zurich, Switzerland
| | - Mareike Sauer
- Division of Surgical Research, University Hospital Zurich, Sternwartstrasse, 14 8091 Zurich, Switzerland
| | - Miriam Lipiski
- Division of Surgical Research, University Hospital Zurich, Sternwartstrasse, 14 8091 Zurich, Switzerland
| | - Thea Fleischmann
- Division of Surgical Research, University Hospital Zurich, Sternwartstrasse, 14 8091 Zurich, Switzerland
| | - Nikola Cesarovic
- Division of Surgical Research, University Hospital Zurich, Sternwartstrasse, 14 8091 Zurich, Switzerland
| | - Christian T. Stoeck
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse, 35 8092 Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse, 35 8092 Zurich, Switzerland
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Miller JJ, Lau AZ, Nielsen PM, McMullen-Klein G, Lewis AJ, Jespersen NR, Ball V, Gallagher FA, Carr CA, Laustsen C, Bøtker HE, Tyler DJ, Schroeder MA. Hyperpolarized [1,4- 13C 2]Fumarate Enables Magnetic Resonance-Based Imaging of Myocardial Necrosis. JACC Cardiovasc Imaging 2018; 11:1594-1606. [PMID: 29248653 PMCID: PMC6231534 DOI: 10.1016/j.jcmg.2017.09.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to determine if hyperpolarized [1,4-13C2]malate imaging could measure cardiomyocyte necrosis after myocardial infarction (MI). BACKGROUND MI is defined by an acute burst of cellular necrosis and the subsequent cascade of structural and functional adaptations. Quantifying necrosis in the clinic after MI remains challenging. Magnetic resonance-based detection of the conversion of hyperpolarized [1,4-13C2]fumarate to [1,4-13C2]malate, enabled by disrupted cell membrane integrity, has measured cellular necrosis in vivo in other tissue types. Our aim was to determine whether hyperpolarized [1,4-13C2]malate imaging could measure necrosis after MI. METHODS Isolated perfused hearts were given hyperpolarized [1,4-13C2]fumarate at baseline, immediately after 20 min of ischemia, and after 45 min of reperfusion. Magnetic resonance spectroscopy measured conversion into [1,4-13C2]malate. Left ventricular function and energetics were monitored throughout the protocol, buffer samples were collected and hearts were preserved for further analyses. For in vivo studies, magnetic resonance spectroscopy and a novel spatial-spectral magnetic resonance imaging sequence were implemented to assess cardiomyocyte necrosis in rats, 1 day and 1 week after cryo-induced MI. RESULTS In isolated hearts, [1,4-13C2]malate production became apparent after 45 min of reperfusion, and increased 2.7-fold compared with baseline. Expression of dicarboxylic acid transporter genes were negligible in healthy and reperfused hearts, and lactate dehydrogenase release and infarct size were significantly increased in reperfused hearts. Nonlinear regression revealed that [1,4-13C2]malate production was induced when adenosine triphosphate was depleted by >50%, below 5.3 mmol/l (R2 = 0.904). In vivo, the quantity of [1,4-13C2]malate visible increased 82-fold over controls 1 day after infarction, maintaining a 31-fold increase 7 days post-infarct. [1,4-13C2]Malate could be resolved using hyperpolarized magnetic resonance imaging in the infarct region one day after MI; [1,4-13C2]malate was not visible in control hearts. CONCLUSIONS Malate production in the infarcted heart appears to provide a specific probe of necrosis acutely after MI, and for at least 1 week afterward. This technique could offer an alternative noninvasive method to measure cellular necrosis in heart disease, and warrants further investigation in patients.
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Affiliation(s)
- Jack J Miller
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, United Kingdom; Department of Physics, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Angus Z Lau
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Physical Sciences, Sunnybrook Research Institute, Toronto, Canada
| | - Per Mose Nielsen
- Department of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Giles McMullen-Klein
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, United Kingdom
| | - Andrew J Lewis
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Vicky Ball
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, United Kingdom
| | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Carolyn A Carr
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, United Kingdom
| | - Christoffer Laustsen
- Department of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Hans Erik Bøtker
- Department of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Damian J Tyler
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Marie A Schroeder
- Department of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus, Denmark.
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Affiliation(s)
- Craig R Malloy
- From the Advanced Imaging Research Center and Departments of Internal Medicine (Division of Cardiology) and Radiology, University of Texas Southwestern Medical Center and VA North Texas Healthcare System, Dallas (C.R.M.); and Advanced Imaging Research Center and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, and Department of Chemistry, University of Texas at Dallas, Richardson (A.D.S.).
| | - A Dean Sherry
- From the Advanced Imaging Research Center and Departments of Internal Medicine (Division of Cardiology) and Radiology, University of Texas Southwestern Medical Center and VA North Texas Healthcare System, Dallas (C.R.M.); and Advanced Imaging Research Center and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, and Department of Chemistry, University of Texas at Dallas, Richardson (A.D.S.)
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31
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Timm KN, Miller JJ, Henry JA, Tyler DJ. Cardiac applications of hyperpolarised magnetic resonance. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 106-107:66-87. [PMID: 31047602 DOI: 10.1016/j.pnmrs.2018.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/14/2018] [Accepted: 05/29/2018] [Indexed: 05/05/2023]
Abstract
Cardiovascular disease is the leading cause of death world-wide. It is increasingly recognised that cardiac pathologies show, or may even be caused by, changes in metabolism, leading to impaired cardiac energetics. The heart turns over 15 times its own weight in ATP every day and thus relies heavily on the availability of substrates and on efficient oxidation to generate this ATP. A number of old and emerging drugs that target different aspects of metabolism are showing promising results with regard to improved cardiac outcomes in patients. A non-invasive imaging technique that could assess the role of different aspects of metabolism in heart disease, as well as measure changes in cardiac energetics due to treatment, would be valuable in the routine clinical care of cardiac patients. Hyperpolarised magnetic resonance spectroscopy and imaging have revolutionised metabolic imaging, allowing real-time metabolic flux assessment in vivo for the first time. In this review we summarise metabolism in the healthy and diseased heart, give an introduction to the hyperpolarisation technique, 'dynamic nuclear polarisation' (DNP), and review the preclinical studies that have thus far explored healthy cardiac metabolism and different models of human heart disease. We furthermore show what advances have been made to translate this technique into the clinic, what technical challenges still remain and what unmet clinical needs and unexplored metabolic substrates still need to be assessed by researchers in this exciting and fast-moving field.
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Affiliation(s)
- Kerstin N Timm
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK.
| | - Jack J Miller
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK; Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, UK; Clarendon Laboratory, Department of Physics, University of Oxford, UK.
| | - John A Henry
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK.
| | - Damian J Tyler
- Department of Physiology, Anatomy and Genetics, University of Oxford, UK; Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, UK.
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32
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Wespi P, Steinhauser J, Kwiatkowski G, Kozerke S. High-resolution hyperpolarized metabolic imaging of the rat heart using k-t PCA and k-t SPARSE. NMR IN BIOMEDICINE 2018; 31:e3876. [PMID: 29244228 DOI: 10.1002/nbm.3876] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 10/07/2017] [Accepted: 11/10/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Patrick Wespi
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Jonas Steinhauser
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Grzegorz Kwiatkowski
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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33
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Mariager CØ, Nielsen PM, Qi H, Ringgaard S, Laustsen C. Hyperpolarized 13
C,15
N2
-urea T2
relaxation changes in acute kidney injury. Magn Reson Med 2017; 80:696-702. [DOI: 10.1002/mrm.27050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/29/2017] [Accepted: 11/29/2017] [Indexed: 01/18/2023]
Affiliation(s)
| | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine; Aarhus University; Aarhus Denmark
| | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine; Aarhus University; Aarhus Denmark
| | - Steffen Ringgaard
- MR Research Centre, Department of Clinical Medicine; Aarhus University; Aarhus Denmark
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine; Aarhus University; Aarhus Denmark
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34
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Fuetterer M, Busch J, Peereboom SM, von Deuster C, Wissmann L, Lipiski M, Fleischmann T, Cesarovic N, Stoeck CT, Kozerke S. Hyperpolarized 13C urea myocardial first-pass perfusion imaging using velocity-selective excitation. J Cardiovasc Magn Reson 2017; 19:46. [PMID: 28637508 PMCID: PMC5480203 DOI: 10.1186/s12968-017-0364-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 06/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A velocity-selective binomial excitation scheme for myocardial first-pass perfusion measurements with hyperpolarized 13C substrates, which preserves bolus magnetization inside the blood pool, is presented. The proposed method is evaluated against gadolinium-enhanced 1H measurements in-vivo. METHODS The proposed excitation with an echo-planar imaging readout was implemented on a clinical CMR system. Dynamic myocardial stress perfusion images were acquired in six healthy pigs after bolus injection of hyperpolarized 13C urea with the velocity-selective vs. conventional excitation, as well as standard 1H gadolinium-enhanced images. Signal-to-noise, contrast-to-noise (CNR) and homogeneity of semi-quantitative perfusion measures were compared between methods based on first-pass signal-intensity time curves extracted from a mid-ventricular slice. Diagnostic feasibility is demonstrated in a case of septal infarction. RESULTS Velocity-selective excitation provides over three-fold reduction in blood pool signal with a two-fold increase in myocardial CNR. Extracted first-pass perfusion curves reveal a significantly reduced variability of semi-quantitative first-pass perfusion measures (12-20%) for velocity-selective excitation compared to conventional excitation (28-93%), comparable to that of reference 1H gadolinium data (9-15%). Overall image quality appears comparable between the velocity-selective hyperpolarized and gadolinium-enhanced imaging. CONCLUSION The feasibility of hyperpolarized 13C first-pass perfusion CMR has been demonstrated in swine. Comparison with reference 1H gadolinium data revealed sufficient data quality and indicates the potential of hyperpolarized perfusion imaging for human applications.
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Affiliation(s)
- Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Julia Busch
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Sophie M. Peereboom
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Constantin von Deuster
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Lukas Wissmann
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Miriam Lipiski
- Division of Surgical Research, University Hospital Zurich, Sternwartstrasse 14, 8091 Zurich, Switzerland
| | - Thea Fleischmann
- Division of Surgical Research, University Hospital Zurich, Sternwartstrasse 14, 8091 Zurich, Switzerland
| | - Nikola Cesarovic
- Division of Surgical Research, University Hospital Zurich, Sternwartstrasse 14, 8091 Zurich, Switzerland
| | - Christian T. Stoeck
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
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35
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Adamson EB, Ludwig KD, Mummy DG, Fain SB. Magnetic resonance imaging with hyperpolarized agents: methods and applications. Phys Med Biol 2017; 62:R81-R123. [PMID: 28384123 DOI: 10.1088/1361-6560/aa6be8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In the past decade, hyperpolarized (HP) contrast agents have been under active development for MRI applications to address the twin challenges of functional and quantitative imaging. Both HP helium (3He) and xenon (129Xe) gases have reached the stage where they are under study in clinical research. HP 129Xe, in particular, is poised for larger scale clinical research to investigate asthma, chronic obstructive pulmonary disease, and fibrotic lung diseases. With advances in polarizer technology and unique capabilities for imaging of 129Xe gas exchange into lung tissue and blood, HP 129Xe MRI is attracting new attention. In parallel, HP 13C and 15N MRI methods have steadily advanced in a wide range of pre-clinical research applications for imaging metabolism in various cancers and cardiac disease. The HP [1-13C] pyruvate MRI technique, in particular, has undergone phase I trials in prostate cancer and is poised for investigational new drug trials at multiple institutions in cancer and cardiac applications. This review treats the methodology behind both HP gases and HP 13C and 15N liquid state agents. Gas and liquid phase HP agents share similar technologies for achieving non-equilibrium polarization outside the field of the MRI scanner, strategies for image data acquisition, and translational challenges in moving from pre-clinical to clinical research. To cover the wide array of methods and applications, this review is organized by numerical section into (1) a brief introduction, (2) the physical and biological properties of the most common polarized agents with a brief summary of applications and methods of polarization, (3) methods for image acquisition and reconstruction specific to improving data acquisition efficiency for HP MRI, (4) the main physical properties that enable unique measures of physiology or metabolic pathways, followed by a more detailed review of the literature describing the use of HP agents to study: (5) metabolic pathways in cancer and cardiac disease and (6) lung function in both pre-clinical and clinical research studies, concluding with (7) some future directions and challenges, and (8) an overall summary.
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Affiliation(s)
- Erin B Adamson
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States of America
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36
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Siddiqui S, Kadlecek S, Pourfathi M, Xin Y, Mannherz W, Hamedani H, Drachman N, Ruppert K, Clapp J, Rizi R. The use of hyperpolarized carbon-13 magnetic resonance for molecular imaging. Adv Drug Deliv Rev 2017; 113:3-23. [PMID: 27599979 PMCID: PMC5783573 DOI: 10.1016/j.addr.2016.08.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/25/2016] [Accepted: 08/27/2016] [Indexed: 02/06/2023]
Abstract
Until recently, molecular imaging using magnetic resonance (MR) has been limited by the modality's low sensitivity, especially with non-proton nuclei. The advent of hyperpolarized (HP) MR overcomes this limitation by substantially enhancing the signal of certain biologically important probes through a process known as external nuclear polarization, enabling real-time assessment of tissue function and metabolism. The metabolic information obtained by HP MR imaging holds significant promise in the clinic, where it could play a critical role in disease diagnosis and therapeutic monitoring. This review will provide a comprehensive overview of the developments made in the field of hyperpolarized MR, including advancements in polarization techniques and delivery, probe development, pulse sequence optimization, characterization of healthy and diseased tissues, and the steps made towards clinical translation.
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Affiliation(s)
- Sarmad Siddiqui
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Stephen Kadlecek
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mehrdad Pourfathi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yi Xin
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - William Mannherz
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hooman Hamedani
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Nicholas Drachman
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kai Ruppert
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Justin Clapp
- Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rahim Rizi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
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37
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Imaging oxygen metabolism with hyperpolarized magnetic resonance: a novel approach for the examination of cardiac and renal function. Biosci Rep 2017; 37:BSR20160186. [PMID: 27899435 PMCID: PMC5270319 DOI: 10.1042/bsr20160186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 12/24/2022] Open
Abstract
Every tissue in the body critically depends on meeting its energetic demands with sufficient oxygen supply. Oxygen supply/demand imbalances underlie the diseases that inflict the greatest socio-economic burden globally. The purpose of this review is to examine how hyperpolarized contrast media, used in combination with MR data acquisition methods, may advance our ability to assess oxygen metabolism non-invasively and thus improve management of clinical disease. We first introduce the concept of hyperpolarization and how hyperpolarized contrast media have been practically implemented to achieve translational and clinical research. We will then analyse how incorporating hyperpolarized contrast media could enable realization of unmet technical needs in clinical practice. We will focus on imaging cardiac and renal oxygen metabolism, as both organs have unique physiological demands to satisfy their requirements for tissue oxygenation, their dysfunction plays a fundamental role in society’s most prevalent diseases, and each organ presents unique imaging challenges. It is our aim that this review attracts a multi-disciplinary audience and sparks collaborations that utilize an exciting, emergent technology to advance our ability to treat patients adversely affected by an oxygen supply/demand mismatch.
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38
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Wigh Lipsø K, Hansen ESS, Tougaard RS, Laustsen C, Ardenkjaer-Larsen JH. Renal MR angiography and perfusion in the pig using hyperpolarized water. Magn Reson Med 2016; 78:1131-1135. [DOI: 10.1002/mrm.26478] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/08/2016] [Accepted: 09/01/2016] [Indexed: 01/20/2023]
Affiliation(s)
- Kasper Wigh Lipsø
- Department of Electrical Engineering; Technical University of Denmark; Kgs Lyngby Denmark
| | - Esben Søvsø Szocska Hansen
- Department of Clinical Medicine, MR Research Centre; Aarhus University; Aarhus Denmark
- Danish Diabetes Academy; Odense Denmark
| | - Rasmus Stilling Tougaard
- Department of Clinical Medicine, MR Research Centre; Aarhus University; Aarhus Denmark
- Department of Cardiology - Research; Aarhus University Hospital; Aarhus Denmark
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre; Aarhus University; Aarhus Denmark
| | - Jan Henrik Ardenkjaer-Larsen
- Department of Electrical Engineering; Technical University of Denmark; Kgs Lyngby Denmark
- GE Healthcare; Brøndby Denmark
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39
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Reed GD, von Morze C, Verkman AS, Koelsch BL, Chaumeil MM, Lustig M, Ronen SM, Bok RA, Sands JM, Larson PEZ, Wang ZJ, Larsen JHA, Kurhanewicz J, Vigneron DB. Imaging Renal Urea Handling in Rats at Millimeter Resolution using Hyperpolarized Magnetic Resonance Relaxometry. ACTA ACUST UNITED AC 2016; 2:125-135. [PMID: 27570835 PMCID: PMC4996281 DOI: 10.18383/j.tom.2016.00127] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In vivo spin spin relaxation time (T2) heterogeneity of hyperpolarized [13C,15N2]urea in the rat kidney was investigated. Selective quenching of the vascular hyperpolarized 13C signal with a macromolecular relaxation agent revealed that a long-T2 component of the [13C,15N2]urea signal originated from the renal extravascular space, thus allowing the vascular and renal filtrate contrast agent pools of the [13C,15N2]urea to be distinguished via multi-exponential analysis. The T2 response to induced diuresis and antidiuresis was performed with two imaging agents: hyperpolarized [13C,15N2]urea and a control agent hyperpolarized bis-1,1-(hydroxymethyl)-1-13C-cyclopropane-2H8. Large T2 increases in the inner-medullar and papilla were observed with the former agent and not the latter during antidiuresis. Therefore, [13C,15N2]urea relaxometry is sensitive to two steps of the renal urea handling process: glomerular filtration and the inner-medullary urea transporter (UT)-A1 and UT-A3 mediated urea concentrating process. Simple motion correction and subspace denoising algorithms are presented to aid in the multi exponential data analysis. Furthermore, a T2-edited, ultra long echo time sequence was developed for sub-2 mm3 resolution 3D encoding of urea by exploiting relaxation differences in the vascular and filtrate pools.
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Affiliation(s)
- Galen D Reed
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Cornelius von Morze
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Alan S Verkman
- Departments of Medicine and Physiology, University of California San Francisco, San Francisco, California, USA
| | - Bertram L Koelsch
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Myriam M Chaumeil
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Michael Lustig
- Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA; Department of Electrical Engineering and Computer Sciences, University of California Berkeley, Berkeley, California, USA
| | - Sabrina M Ronen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Jeff M Sands
- Department of Medicine, Renal Division, Emory University, Atlanta, Georgia, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Jan Henrik Ardenkjær Larsen
- GE Healthcare, Brøndby, Denmark; Department of Electrical Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
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40
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Reed GD, von Morze C, Verkman AS, Koelsch BL, Chaumeil MM, Lustig M, Ronen SM, Bok RA, Sands JM, Larson PEZ, Wang ZJ, Larsen JHA, Kurhanewicz J, Vigneron DB. Imaging Renal Urea Handling in Rats at Millimeter Resolution using Hyperpolarized Magnetic Resonance Relaxometry. Tomography 2016. [PMID: 27570835 DOI: 10.18383/j.tom2016.00127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023] Open
Abstract
In vivo spin spin relaxation time (T2) heterogeneity of hyperpolarized [13C,15N2]urea in the rat kidney was investigated. Selective quenching of the vascular hyperpolarized 13C signal with a macromolecular relaxation agent revealed that a long-T2 component of the [13C,15N2]urea signal originated from the renal extravascular space, thus allowing the vascular and renal filtrate contrast agent pools of the [13C,15N2]urea to be distinguished via multi-exponential analysis. The T2 response to induced diuresis and antidiuresis was performed with two imaging agents: hyperpolarized [13C,15N2]urea and a control agent hyperpolarized bis-1,1-(hydroxymethyl)-1-13C-cyclopropane-2H8. Large T2 increases in the inner-medullar and papilla were observed with the former agent and not the latter during antidiuresis. Therefore, [13C,15N2]urea relaxometry is sensitive to two steps of the renal urea handling process: glomerular filtration and the inner-medullary urea transporter (UT)-A1 and UT-A3 mediated urea concentrating process. Simple motion correction and subspace denoising algorithms are presented to aid in the multi exponential data analysis. Furthermore, a T2-edited, ultra long echo time sequence was developed for sub-2 mm3 resolution 3D encoding of urea by exploiting relaxation differences in the vascular and filtrate pools.
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Affiliation(s)
- Galen D Reed
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Cornelius von Morze
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Alan S Verkman
- Departments of Medicine and Physiology, University of California San Francisco, San Francisco, California, USA
| | - Bertram L Koelsch
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Myriam M Chaumeil
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Michael Lustig
- Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA; Department of Electrical Engineering and Computer Sciences, University of California Berkeley, Berkeley, California, USA
| | - Sabrina M Ronen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Jeff M Sands
- Department of Medicine, Renal Division, Emory University, Atlanta, Georgia, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Jan Henrik Ardenkjær Larsen
- GE Healthcare, Brøndby, Denmark; Department of Electrical Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA; Graduate Group in Bioengineering University of California San Francisco, San Francisco, California, USA, and University of California Berkeley, Berkeley, California, USA
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41
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Lau AZ, Miller JJ, Tyler DJ. Mapping of intracellular pH in the in vivo rodent heart using hyperpolarized [1-13C]pyruvate. Magn Reson Med 2016; 77:1810-1817. [PMID: 27173806 PMCID: PMC5412837 DOI: 10.1002/mrm.26260] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/14/2016] [Accepted: 04/06/2016] [Indexed: 12/22/2022]
Abstract
Purpose To demonstrate the feasibility of mapping intracellular pH within the in vivo rodent heart. Alterations in cardiac acid‐base balance can lead to acute contractile depression and alterations in Ca2+ signaling. The transient reduction in adenosine triphosphate (ATP) consumption and cardiac contractility may be initially beneficial; however, sustained pH changes can be maladaptive, leading to myocardial damage and electrical arrhythmias. Methods Spectrally selective radiofrequency (RF) pulses were used to excite the
HCO3− and CO2 resonances individually while preserving signal from the injected hyperpolarized [1‐13C]pyruvate. The large flip angle pulses were placed within a three‐dimensional (3D) imaging acquisition, which exploited CA‐mediated label exchange between
HCO3− and CO2. Images at 4.5 × 4.5 × 5 mm3 resolution were obtained in the in vivo rodent heart. The technique was evaluated in healthy rodents scanned at baseline and during high cardiac workload induced by dobutamine infusion. Results The intracellular pH was measured to be 7.15 ± 0.04 at baseline, and decreased to 6.90 ± 0.06 following 15 min of continuous β‐adrenergic stimulation. Conclusions Volumetric maps of intracellular pH can be obtained following an injection of hyperpolarized [1‐13C]pyruvate. The new method is anticipated to enable assessment of stress‐inducible ischemia and potential ventricular arrythmogenic substrates within the ischemic heart. Magn Reson Med 77:1810–1817, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Angus Z Lau
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK.,Department of Physiology, Anatomy, and Genetics, University of Oxford, UK
| | - Jack J Miller
- Department of Physiology, Anatomy, and Genetics, University of Oxford, UK.,Department of Physics, Clarendon Laboratory, University of Oxford, UK
| | - Damian J Tyler
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK.,Department of Physiology, Anatomy, and Genetics, University of Oxford, UK
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