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Larson PEZ, Bernard JML, Bankson JA, Bøgh N, Bok RA, Chen AP, Cunningham CH, Gordon J, Hövener JB, Laustsen C, Mayer D, McLean MA, Schilling F, Slater J, Vanderheyden JL, von Morze C, Vigneron DB, Xu D. Current methods for hyperpolarized [1- 13C]pyruvate MRI human studies. Magn Reson Med 2024; 91:2204-2228. [PMID: 38441968 PMCID: PMC10997462 DOI: 10.1002/mrm.29875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/12/2023] [Accepted: 09/06/2023] [Indexed: 03/07/2024]
Abstract
MRI with hyperpolarized (HP) 13C agents, also known as HP 13C MRI, can measure processes such as localized metabolism that is altered in numerous cancers, liver, heart, kidney diseases, and more. It has been translated into human studies during the past 10 years, with recent rapid growth in studies largely based on increasing availability of HP agent preparation methods suitable for use in humans. This paper aims to capture the current successful practices for HP MRI human studies with [1-13C]pyruvate-by far the most commonly used agent, which sits at a key metabolic junction in glycolysis. The paper is divided into four major topic areas: (1) HP 13C-pyruvate preparation; (2) MRI system setup and calibrations; (3) data acquisition and image reconstruction; and (4) data analysis and quantification. In each area, we identified the key components for a successful study, summarized both published studies and current practices, and discuss evidence gaps, strengths, and limitations. This paper is the output of the "HP 13C MRI Consensus Group" as well as the ISMRM Hyperpolarized Media MR and Hyperpolarized Methods and Equipment study groups. It further aims to provide a comprehensive reference for future consensus, building as the field continues to advance human studies with this metabolic imaging modality.
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Affiliation(s)
- Peder EZ 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 and University of California, Berkeley, CA
94143, USA
| | - Jenna ML Bernard
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | - James A Bankson
- Department of Imaging Physics, MD Anderson Medical Center,
Houston, TX, USA
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | | | - Charles H Cunningham
- Physical Sciences, Sunnybrook Research Institute, Toronto,
Ontario, Canada
- Department of Medical Biophysics, University of Toronto,
Toronto, Ontario, Canada
| | - Jeremy Gordon
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North
Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University
Medical Center Schleswig-Holstein (UKSH), Kiel University, Am Botanischen Garten 14,
24118, Kiel, Germany
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
| | - Dirk Mayer
- Department of Diagnostic Radiology and Nuclear Medicine,
University of Maryland School of Medicine, Baltimore, MD, USA
- Greenebaum Cancer Center, University of Maryland School
of Medicine, Baltimore, MD, USA
| | - Mary A McLean
- Department of Radiology, University of Cambridge,
Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of
Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
| | - Franz Schilling
- Department of Nuclear Medicine, School of Medicine,
Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich,
Germany
| | - James Slater
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | | | | | - Daniel B Vigneron
- 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 and University of California, Berkeley, CA
94143, USA
| | - Duan Xu
- 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 and University of California, Berkeley, CA
94143, USA
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Gullaksen S, Vernstrøm L, Sørensen SS, Ringgaard S, Laustsen C, Funck KL, Poulsen PL, Laugesen E. Correction: Separate and combined effects of semaglutide and empagliflozin on kidney oxygenation and perfusion in people with type 2 diabetes: a randomised trial. Diabetologia 2024:10.1007/s00125-024-06167-8. [PMID: 38739291 DOI: 10.1007/s00125-024-06167-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Affiliation(s)
- Søren Gullaksen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
| | - Liv Vernstrøm
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Steffen S Sørensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Endocrinology and Internal Medicine, 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
| | - Kristian L Funck
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Per L Poulsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Esben Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
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Rasmussen CW, Bøgh N, Ringgaard S, Birn H, Vaeggemose M, Schulte RF, Laustsen C. Daytime Variation in Kidney Perfusion, Oxygenation, and Sodium Concentration Assessed by Multiparametric MRI in Healthy Volunteers. J Magn Reson Imaging 2024; 59:1603-1611. [PMID: 37656067 DOI: 10.1002/jmri.28983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND MRI can provide information on kidney structure, perfusion, and oxygenation. Furthermore, it allows for the assessment of kidney sodium concentrations and handling, allowing multiparametric evaluation of kidney physiology. Multiparametric MRI is promising for establishing prognosis and monitoring treatment responses in kidney diseases, but its intraindividual variation during the day is unresolved. PURPOSE To investigate the variation in multiparametric MRI measurements from the morning to the evening. STUDY TYPE Prospective. POPULATION Ten healthy volunteers, aged 29 ± 5 without history of kidney disease. FIELD STRENGTH/SEQUENCE 3 T/T1 mapping, blood-oxygen level dependent imaging, arterial spin labeling perfusion imaging, diffusion weighted imaging, and sodium imaging. ASSESSMENT A multiparametric MRI protocol, yielding T1, R2*, ADC, renal blood flow and renal sodium levels, was acquired in the morning, noon, and evening. The participants were fasting prior to the first examination. Urine biochemical analyses were performed to complement MRI data. The cortex and medulla were analyzed separately in a semi-automatic fashion, and gradients of total sodium concentration (TSC) and R2* gradients were calculated from outer cortex to inner medulla. STATISTICAL TEST Analyses of variance and mixed-effects models to estimate differences from time of day. Coefficients of variation to assess variability within and between participants. A P-value <0.05 was considered statistically significant. RESULTS The coefficients of variation varied from 5% to 18% for proton-based parametric sequences, while it was 38% for TSC over a day. DATA CONCLUSION Multiparametric MRI is stable over the day. The coefficients of variation over a day were lower for proton multiparametric MRI, but higher for sodium MRI. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Camilla W Rasmussen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steffen Ringgaard
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henrik Birn
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Vaeggemose
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- GE HealthCare, Broendby, Denmark
| | | | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Andelius TCK, Hansen ESS, Bøgh N, Pedersen MV, Kyng KJ, Henriksen TB, Laustsen C. Hyperpolarized 13C magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy: First investigations in a large animal model. NMR Biomed 2024; 37:e5110. [PMID: 38317333 DOI: 10.1002/nbm.5110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/03/2023] [Accepted: 01/07/2024] [Indexed: 02/07/2024]
Abstract
Early biomarkers of cerebral damage are essential for accurate prognosis, timely intervention, and evaluation of new treatment modalities in newborn infants with hypoxia and ischemia at birth. Hyperpolarized 13C magnetic resonance imaging (MRI) is a novel method with which to quantify metabolism in vivo with unprecedented sensitivity. We aimed to investigate the applicability of hyperpolarized 13C MRI in a newborn piglet model and whether this method may identify early changes in cerebral metabolism after a standardized hypoxic-ischemic (HI) insult. Six piglets were anesthetized and subjected to a standardized HI insult. Imaging was performed prior to and 2 h after the insult on a 3-T MR scanner. For 13C studies, [1-13C]pyruvate was hyperpolarized in a commercial polarizer. Following intravenous injection, images were acquired using metabolic-specific imaging. HI resulted in a metabolic shift with a decrease in pyruvate to bicarbonate metabolism and an increase in pyruvate to lactate metabolism (lactate/bicarbonate ratio, mean [SD]; 2.28 [0.36] vs. 3.96 [0.91]). This is the first study to show that hyperpolarized 13C MRI can be used in newborn piglets and applied to evaluate early changes in cerebral metabolism after an HI insult.
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Affiliation(s)
- Ted C K Andelius
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | | | - Nikolaj Bøgh
- The MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Mette V Pedersen
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Kasper J Kyng
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Tine B Henriksen
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
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Christensen NV, Holm R, Sanchez JD, Hansen ESS, Lerche MH, Ardenkjær-Larsen JH, Laustsen C, Bertelsen LB. A continuous flow bioreactor system for high-throughput hyperpolarized metabolic flux analysis. NMR Biomed 2024; 37:e5107. [PMID: 38279190 DOI: 10.1002/nbm.5107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/28/2024]
Abstract
Hyperpolarized carbon-13 labeled compounds are increasingly being used in medical MR imaging (MRI) and MR imaging (MRI) and spectroscopy (MRS) research, due to its ability to monitor tissue and cell metabolism in real-time. Although radiological biomarkers are increasingly being considered as clinical indicators, biopsies are still considered the gold standard for a large variety of indications. Bioreactor systems can play an important role in biopsy examinations because of their ability to provide a physiochemical environment that is conducive for therapeutic response monitoring ex vivo. We demonstrate here a proof-of-concept bioreactor and microcoil receive array setup that allows for ex vivo preservation and metabolic NMR spectroscopy on up to three biopsy samples simultaneously, creating an easy-to-use and robust way to simultaneously run multisample carbon-13 hyperpolarization experiments. Experiments using hyperpolarized [1-13C]pyruvate on ML-1 leukemic cells in the bioreactor setup were performed and the kinetic pyruvate-to-lactate rate constants ( k PL ) extracted. The coefficient of variation of the experimentally found k PL s for five repeated experiments was C V = 35 % . With this statistical power, treatment effects of 30%-40% change in lactate production could be easily differentiable with only a few hyperpolarization dissolutions on this setup. Furthermore, longitudinal experiments showed preservation of ML-1 cells in the bioreactor setup for at least 6 h. Rat brain tissue slices were also seen to be preserved within the bioreactor for at least 1 h. This validation serves as the basis for further optimization and upscaling of the setup, which undoubtedly has huge potential in high-throughput studies with various biomarkers and tissue types.
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Affiliation(s)
| | - Rikke Holm
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Esben S S Hansen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mathilde H Lerche
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Christoffer Laustsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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6
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Hamelink TL, Ogurlu B, Pamplona CC, Castelein J, Bennedsgaard SS, Qi H, Weiss T, Lantinga VA, Pool MBF, Laustsen C, Jespersen B, Leuvenink HGD, Ringgaard S, Borra RJH, Keller AK, Moers C. Magnetic resonance imaging as a noninvasive adjunct to conventional assessment of functional differences between kidneys in vivo and during ex vivo normothermic machine perfusion. Am J Transplant 2024:S1600-6135(24)00272-7. [PMID: 38615901 DOI: 10.1016/j.ajt.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/26/2024] [Accepted: 04/07/2024] [Indexed: 04/16/2024]
Abstract
Normothermic machine perfusion (NMP) is increasingly considered for pretransplant kidney quality assessment. However, fundamental questions about differences between in vivo and ex vivo renal function, as well as the impact of ischemic injury on ex vivo physiology, remain unanswered. This study utilized magnetic resonance imaging (MRI), alongside conventional parameters to explore differences between in vivo and ex vivo renal function and the impact of warm ischemia on a kidney's behavior ex vivo. Renal MRI scans and samples were obtained from living pigs (n = 30) in vivo. Next, kidney pairs were procured and exposed to minimal, or 75 minutes of warm ischemia, followed by 6 hours of hypothermic machine perfusion. Both kidneys simultaneously underwent 6-hour ex vivo perfusion in MRI-compatible NMP circuits to obtain multiparametric MRI data. Ischemically injured ex vivo kidneys showed a significantly altered regional blood flow distribution compared to in vivo and minimally damaged organs. Both ex vivo groups showed diffusion restriction relative to in vivo. Our findings underscore the differences between in vivo and ex vivo MRI-based renal characteristics. Therefore, when assessing organ viability during NMP, it should be considered to incorporate parameters beyond the conventional functional markers that are common in vivo.
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Affiliation(s)
- Tim L Hamelink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Baran Ogurlu
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Carolina C Pamplona
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Johannes Castelein
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Haiyun Qi
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Weiss
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Veerle A Lantinga
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Merel B F Pool
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Jespersen
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Henri G D Leuvenink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Steffen Ringgaard
- Department of Clinical Medicine, MR Research Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Ronald J H Borra
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Anna K Keller
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Cyril Moers
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Gaemelke T, Laustsen C, Feys P, Folkestad L, Andersen MS, Jørgensen NR, Jørgensen ML, Jespersen SN, Ringgaard S, Eskildsen SF, Dalgas U, Hvid LG. Effects of power training in older patients with multiple sclerosis on neurodegeneration, neuromuscular function, and physical function. A study protocol for the "power training in older multiple sclerosis patients (PoTOMS) randomized control trial. Contemp Clin Trials Commun 2024; 38:101279. [PMID: 38444875 PMCID: PMC10912361 DOI: 10.1016/j.conctc.2024.101279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/24/2024] [Accepted: 02/17/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Approximately one-third of all persons with multiple sclerosis (pwMS) are older, i.e., having an age ≥60 years. Whilst ageing and MS separately elicit deteriorating effects on brain morphology, neuromuscular function, and physical function, the combination of ageing and MS may pose a particular challenge. To counteract such detrimental changes, power training (i.e., a type of resistance exercise focusing on moderate-to-high loading at maximal intended movement velocity) presents itself as a viable and highly effective solution. Power training is known to positively impact physical function, neuromuscular function, as well as brain morphology. Existing evidence is promising but limited to young and middle-aged pwMS, with the effects of power training remaining to be elucidated in older pwMS. Methods The presented 'Power Training in Older MS patients (PoTOMS)' trial is a national, multi-center, parallel-group, randomized controlled trial. The trial compares 24 weeks of usual care(n = 30) to 24 weeks of usual care and power training (n = 30). The primary outcome is whole brain atrophy rate. The secondary outcomes include changes in brain micro and macro structures, neuromuscular function, physical function, cognitive function, bone health, and patient-reported outcomes. Ethics and dissemination The presented study is approved by The Regional Ethics Committee (reference number 1-10-72-222-20) and registered at the Danish Data Protection Agency (reference number 2016-051-000001). All study findings will be published in scientific peer-reviewed journals and presented at relevant scientific conferences independent of the results. The www.clinicaltrials.gov identifier is NCT04762342.
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Affiliation(s)
- Tobias Gaemelke
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Peter Feys
- REVAL, Rehabilitation Research Center, BIOMED, Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Lars Folkestad
- Department of Endocrinology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | | | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Sune Nørhøj Jespersen
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
- Center of Functionally Integrative Neuroscience and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steffen Ringgaard
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Simon F. Eskildsen
- Center of Functionally Integrative Neuroscience and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lars G. Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- The Danish MS Hospitals, Ry and Haslev, Denmark
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8
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Chaumeil MM, Bankson JA, Brindle KM, Epstein S, Gallagher FA, Grashei M, Guglielmetti C, Kaggie JD, Keshari KR, Knecht S, Laustsen C, Schmidt AB, Vigneron D, Yen YF, Schilling F. New Horizons in Hyperpolarized 13C MRI. Mol Imaging Biol 2024; 26:222-232. [PMID: 38147265 PMCID: PMC10972948 DOI: 10.1007/s11307-023-01888-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/27/2023]
Abstract
Hyperpolarization techniques significantly enhance the sensitivity of magnetic resonance (MR) and thus present fascinating new directions for research and applications with in vivo MR imaging and spectroscopy (MRI/S). Hyperpolarized 13C MRI/S, in particular, enables real-time non-invasive assessment of metabolic processes and holds great promise for a diverse range of clinical applications spanning fields like oncology, neurology, and cardiology, with a potential for improving early diagnosis of disease, patient stratification, and therapy response assessment. Despite its potential, technical challenges remain for achieving clinical translation. This paper provides an overview of the discussions that took place at the international workshop "New Horizons in Hyperpolarized 13C MRI," in March 2023 at the Bavarian Academy of Sciences and Humanities, Munich, Germany. The workshop covered new developments, as well as future directions, in topics including polarization techniques (particularly focusing on parahydrogen-based methods), novel probes, considerations related to data acquisition and analysis, and emerging clinical applications in oncology and other fields.
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Affiliation(s)
- Myriam M Chaumeil
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA.
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
| | - James A Bankson
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | | | - Ferdia A Gallagher
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Centre, Cambridge, UK
| | - Martin Grashei
- Department of Nuclear Medicine, TUM School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Caroline Guglielmetti
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Joshua D Kaggie
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Kayvan R Keshari
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
- Weill Cornell Graduate School, New York City, NY, USA
| | | | - Christoffer Laustsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
| | - Andreas B Schmidt
- Partner Site Freiburg and German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5a, 79106, Freiburg, Germany
- Department of Chemistry, Integrative Biosciences (Ibio), Karmanos Cancer Institute (KCI), Wayne State University, Detroit, MI, 48202, USA
| | - Daniel Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Yi-Fen Yen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Franz Schilling
- Department of Nuclear Medicine, TUM School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
- Partner Site Freiburg and German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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9
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Bøgh N, Sørensen CB, Alstrup AKO, Hansen ESS, Andersen OM, Laustsen C. Mice and minipigs with compromised expression of the Alzheimer's disease gene SORL1 show cerebral metabolic disturbances on hyperpolarized [1- 13C]pyruvate and sodium MRI. Brain Commun 2024; 6:fcae114. [PMID: 38650831 PMCID: PMC11034025 DOI: 10.1093/braincomms/fcae114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/24/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
The sortilin-related receptor 1 (SORL1) gene, encoding the cellular endosomal sorting-related receptor with A-type repeats (SORLA), is now established as a causal gene for Alzheimer's disease. As the latest addition to the list of causal genes, the pathophysiological effects and biomarker potential of SORL1 variants remain relatively undiscovered. Metabolic dysfunction is, however, well described in patients with Alzheimer's disease and is used as an imaging biomarker in clinical diagnosis settings. To understand the metabolic consequences of loss-of-function SORL1 mutations, we applied two metabolic MRI technologies, sodium (23Na) MRI and MRI with hyperpolarized [1-13C]pyruvate, in minipigs and mice with compromised expression of SORL1. At the age analysed here, both animal models display no conventional imaging evidence of neurodegeneration but show biochemical signs of elevated amyloid production, thus representing the early preclinical disease. With hyperpolarized MRI, the exchange from [1-13C]pyruvate to [1-13C]lactate and 13C-bicarbonate was decreased by 32 and 23%, respectively, in the cerebrum of SORL1-haploinsufficient minipigs. A robust 11% decrease in the sodium content was observed with 23Na-MRI in the same minipigs. Comparably, the brain sodium concentration gradually decreased from control to SORL1 haploinsufficient (-11%) to SORL1 knockout mice (-23%), suggesting a gene dose dependence in the metabolic dysfunction. The present study highlights that metabolic MRI technologies are sensitive to the functional, metabolic consequences of Alzheimer's disease and Alzheimer's disease-linked genotypes. Further, the study suggests a potential avenue of research into the mechanisms of metabolic alterations by SORL1 mutations and their potential role in neurodegeneration.
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Affiliation(s)
- Nikolaj Bøgh
- Department of Clinical Medicine, The MR Research Centre, Aarhus University, 8200 Aarhus, Denmark
- A&E, Gødstrup Hospital, 7400 Herning, Denmark
| | | | - Aage K O Alstrup
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
- Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Esben S S Hansen
- Department of Clinical Medicine, The MR Research Centre, Aarhus University, 8200 Aarhus, Denmark
| | - Olav M Andersen
- Department of Biomedicine, Aarhus University, 8200 Aarhus, Denmark
| | - Christoffer Laustsen
- Department of Clinical Medicine, The MR Research Centre, Aarhus University, 8200 Aarhus, Denmark
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10
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Bøgh N, Vaeggemose M, Schulte RF, Hansen ESS, Laustsen C. Repeatability of deuterium metabolic imaging of healthy volunteers at 3 T. Eur Radiol Exp 2024; 8:44. [PMID: 38472611 PMCID: PMC10933246 DOI: 10.1186/s41747-024-00426-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Magnetic resonance (MR) imaging of deuterated glucose, termed deuterium metabolic imaging (DMI), is emerging as a biomarker of pathway-specific glucose metabolism in tumors. DMI is being studied as a useful marker of treatment response in a scan-rescan scenario. This study aims to evaluate the repeatability of brain DMI. METHODS A repeatability study was performed in healthy volunteers from December 2022 to March 2023. The participants consumed 75 g of [6,6'-2H2]glucose. The delivery of 2H-glucose to the brain and its conversion to 2H-glutamine + glutamate, 2H-lactate, and 2H-water DMI was imaged at baseline and at 30, 70, and 120 min. DMI was performed using MR spectroscopic imaging on a 3-T system equipped with a 1H/2H-tuned head coil. Coefficients of variation (CoV) were computed for estimation of repeatability and between-subject variability. In a set of exploratory analyses, the variability effects of region, processing, and normalization were estimated. RESULTS Six male participants were recruited, aged 34 ± 6.5 years (mean ± standard deviation). There was 42 ± 2.7 days between sessions. Whole-brain levels of glutamine + glutamate, lactate, and glucose increased to 3.22 ± 0.4 mM, 1.55 ± 0.3 mM, and 3 ± 0.7 mM, respectively. The best signal-to-noise ratio and repeatability was obtained at the 120-min timepoint. Here, the within-subject whole-brain CoVs were -10% for all metabolites, while the between-subject CoVs were -20%. CONCLUSIONS DMI of glucose and its downstream metabolites is feasible and repeatable on a clinical 3 T system. TRIAL REGISTRATION ClinicalTrials.gov, NCT05402566 , registered the 25th of May 2022. RELEVANCE STATEMENT Brain deuterium metabolic imaging of healthy volunteers is repeatable and feasible at clinical field strengths, enabling the study of shifts in tumor metabolism associated with treatment response. KEY POINTS • Deuterium metabolic imaging is an emerging tumor biomarker with unknown repeatability. • The repeatability of deuterium metabolic imaging is on par with FDG-PET. • The study of deuterium metabolic imaging in clinical populations is feasible.
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Affiliation(s)
- Nikolaj Bøgh
- The MR Research Centre, Dept. Of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark.
- A&E, Gødstrup Hospital, Herning, Denmark.
| | - Michael Vaeggemose
- The MR Research Centre, Dept. Of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
- GE HealthCare, Brondby, Denmark
| | | | - Esben S S Hansen
- The MR Research Centre, Dept. Of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
| | - Christoffer Laustsen
- The MR Research Centre, Dept. Of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
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11
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Gullaksen S, Vernstrøm L, Sørensen SS, Ringgaard S, Laustsen C, Birn H, Funck KL, Poulsen PL, Laugesen E. The effects of semaglutide, empagliflozin and their combination on the kidney sodium signal from magnetic resonance imaging: A prespecified, secondary analysis from a randomized, clinical trial. J Diabetes Complications 2024; 38:108673. [PMID: 38219335 DOI: 10.1016/j.jdiacomp.2023.108673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/17/2023] [Accepted: 12/24/2023] [Indexed: 01/16/2024]
Abstract
AIMS To evaluate the effect of treatment with semaglutide and empagliflozin on the cortico-medullary sodium gradient (MCR; medulla/cortex ratio), urine sodium/creatinine ratio (UNACR), and estimated plasma volume (ePV) and to compare the MCR between persons with and without type 2 diabetes. METHODS Using the 23Na magnetic resonance imaging (23Na-MRI) technique, we investigated the effects of 32 weeks of treatment with semaglutide, empagliflozin or their combination on MCR in 65 participants with type 2 diabetes and high risk of cardiovascular disease. The participants were recruited from a randomized, controlled interventional trial and further characterized by UNACR and ePV. In addition, in a cross-sectional design, we compared MCR by 23Na-MRI in 12 persons with type 2 diabetes and 17 matched controls. Data from the interventional trial were analyzed using a single, multivariate linear mixed model strategy for repeated measurements. Data from the cross-sectional study were analyzed by fitting a linear regression model adjusted for age and sex. RESULTS Compared to placebo, semaglutide, but not empagliflozin, significantly decreased the MCR (-9 %, 95%CI (-18, -0.06)%, p = 0.035 and -0.05 %, 95%CI(-0.15, 0.05)%, p = 0.319, respectively). The UNACR decreased in the semaglutide group(-35 %, 95 % CI(-52, -14) %, p = 0.003) but not in the empagliflozin group (7 %, 95 % CI(-21, 44)%, p = 0.657), whereas the ePV decreased in the combination group. The MCR was not different between persons with and without type 2 diabetes. CONCLUSION 23Na magnetic resonance imaging can identify drug induced changes in the MCR in persons with type 2 diabetes, and 32 weeks of semaglutide decreases the MCR in such persons. There is no difference in the MCR between persons with and without type 2 diabetes. TRIAL NUMBER AND REGISTRY EUDRACT 2019-000781-38, clinicaltrialsregister.eu.
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Affiliation(s)
- Søren Gullaksen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark; Department of Internal Medicine & Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark; Department of Medicine, Regional Hospital Horsens, 8700 Horsens, Denmark.
| | - Liv Vernstrøm
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark; Department of Internal Medicine & Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Steffen S Sørensen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark; Department of Internal Medicine & Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | | | | | - Henrik Birn
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark; Department of Renal Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark; Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Kristian L Funck
- Department of Internal Medicine & Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark; Steno Diabetes Center, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Per L Poulsen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark; Steno Diabetes Center, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Esben Laugesen
- Diagnostic Centre, Silkeborg Regional Hospital, 8600 Silkeborg, Denmark; Steno Diabetes Center, Aarhus University Hospital, 8200 Aarhus N, Denmark
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12
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Christensen NV, Vaeggemose M, Bøgh N, Hansen ESS, Olesen JL, Kim Y, Vigneron DB, Gordon JW, Jespersen SN, Laustsen C. A user independent denoising method for x-nuclei MRI and MRS. Magn Reson Med 2023; 90:2539-2556. [PMID: 37526128 DOI: 10.1002/mrm.29817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE X-nuclei (also called non-proton MRI) MRI and spectroscopy are limited by the intrinsic low SNR as compared to conventional proton imaging. Clinical translation of x-nuclei examination warrants the need of a robust and versatile tool improving image quality for diagnostic use. In this work, we compare a novel denoising method with fewer inputs to the current state-of-the-art denoising method. METHODS Denoising approaches were compared on human acquisitions of sodium (23 Na) brain, deuterium (2 H) brain, carbon (13 C) heart and brain, and simulated dynamic hyperpolarized 13 C brain scans, with and without additional noise. The current state-of-the-art denoising method Global-local higher order singular value decomposition (GL-HOSVD) was compared to the few-input method tensor Marchenko-Pastur principal component analysis (tMPPCA). Noise-removal was quantified by residual distributions, and statistical analyses evaluated the differences in mean-square-error and Bland-Altman analysis to quantify agreement between original and denoised results of noise-added data. RESULTS GL-HOSVD and tMPPCA showed similar performance for the variety of x-nuclei data analyzed in this work, with tMPPCA removing ˜5% more noise on average over GL-HOSVD. The mean ratio between noise-added and denoising reproducibility coefficients of the Bland-Altman analysis when compared to the original are also similar for the two methods with 3.09 ± 1.03 and 2.83 ± 0.79 for GL-HOSVD and tMPPCA, respectively. CONCLUSION The strength of tMPPCA lies in the few-input approach, which generalizes well to different data sources. This makes the use of tMPPCA denoising a robust and versatile tool in x-nuclei imaging improvements and the preferred denoising method.
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Affiliation(s)
| | - Michael Vaeggemose
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- GE Healthcare, Brøndby, Denmark
| | - Nikolaj Bøgh
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- A&E, Gødstrup Hospital, Herning, Denmark
| | - Esben S S Hansen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jonas L Olesen
- Center of Functionally Integrative Neuroscience (CFIN) and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Sune N Jespersen
- Center of Functionally Integrative Neuroscience (CFIN) and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Larson PE, Bernard JM, Bankson JA, Bøgh N, Bok RA, Chen AP, Cunningham CH, Gordon J, Hövener JB, Laustsen C, Mayer D, McLean MA, Schilling F, Slater J, Vanderheyden JL, von Morze C, Vigneron DB, Xu D, Group THCMC. Current Methods for Hyperpolarized [1-13C]pyruvate MRI Human Studies. ArXiv 2023:arXiv:2309.04040v2. [PMID: 37731660 PMCID: PMC10508833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
MRI with hyperpolarized (HP) 13C agents, also known as HP 13C MRI, can measure processes such as localized metabolism that is altered in numerous cancers, liver, heart, kidney diseases, and more. It has been translated into human studies during the past 10 years, with recent rapid growth in studies largely based on increasing availability of hyperpolarized agent preparation methods suitable for use in humans. This paper aims to capture the current successful practices for HP MRI human studies with [1-13C]pyruvate - by far the most commonly used agent, which sits at a key metabolic junction in glycolysis. The paper is divided into four major topic areas: (1) HP 13C-pyruvate preparation, (2) MRI system setup and calibrations, (3) data acquisition and image reconstruction, and (4) data analysis and quantification. In each area, we identified the key components for a successful study, summarized both published studies and current practices, and discuss evidence gaps, strengths, and limitations. This paper is the output of the HP 13C MRI Consensus Group as well as the ISMRM Hyperpolarized Media MR and Hyperpolarized Methods & Equipment study groups. It further aims to provide a comprehensive reference for future consensus building as the field continues to advance human studies with this metabolic imaging modality.
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15
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Madsen S, Bak SY, Yde CC, Jensen HM, Knudsen TA, Bæch-Laursen C, Holst JJ, Laustsen C, Hedemann MS. Unravelling Effects of Rosemary ( Rosmarinus officinalis L.) Extract on Hepatic Fat Accumulation and Plasma Lipid Profile in Rats Fed a High-Fat Western-Style Diet. Metabolites 2023; 13:974. [PMID: 37755254 PMCID: PMC10534343 DOI: 10.3390/metabo13090974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/11/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023] Open
Abstract
The objective of the study was to investigate the preventive effect on obesity-related conditions of rosemary (Rosmarinus officinalis L.) extract (RE) in young, healthy rats fed a high-fat Western-style diet to complement the existing knowledge gap concerning the anti-obesity effects of RE in vivo. Sprague Dawley rats (71.3 ± 0.46 g) were fed a high-fat Western-style diet (WD) or WD containing either 1 g/kg feed or 4 g/kg feed RE for six weeks. A group fed standard chow served as a negative control. The treatments did not affect body weight; however, the liver fat percentage was reduced in rats fed RE, and NMR analyses of liver tissue indicated that total cholesterol and triglycerides in the liver were reduced. In plasma, HDL cholesterol was increased while triglycerides were decreased. Rats fed high RE had significantly increased fasting plasma concentrations of Glucagon-like peptide-1 (GLP-1). Proteomics analyses of liver tissue showed that RE increased enzymes involved in fatty acid oxidation, possibly associated with the higher fasting GLP-1 levels, which may explain the improvement of the overall lipid profile and hepatic fat accumulation. Furthermore, high levels of succinic acid in the cecal content of RE-treated animals suggested a modulation of the microbiota composition. In conclusion, our results suggest that RE may alleviate the effects of consuming a high-fat diet through increased GLP-1 secretion and changes in microbiota composition.
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Affiliation(s)
- Sidsel Madsen
- Department of Animal and Veterinary Sciences, Aarhus University, Blichers Allé 20, DK-8830 Tjele, Denmark
| | - Steffen Yde Bak
- IFF—Nutrition Biosciences Aps, Edwin Rahrs Vej 38, DK-8220 Brabrand, Denmark; (S.Y.B.); (C.C.Y.); (H.M.J.); (T.A.K.)
| | - Christian Clement Yde
- IFF—Nutrition Biosciences Aps, Edwin Rahrs Vej 38, DK-8220 Brabrand, Denmark; (S.Y.B.); (C.C.Y.); (H.M.J.); (T.A.K.)
| | - Henrik Max Jensen
- IFF—Nutrition Biosciences Aps, Edwin Rahrs Vej 38, DK-8220 Brabrand, Denmark; (S.Y.B.); (C.C.Y.); (H.M.J.); (T.A.K.)
| | - Tine Ahrendt Knudsen
- IFF—Nutrition Biosciences Aps, Edwin Rahrs Vej 38, DK-8220 Brabrand, Denmark; (S.Y.B.); (C.C.Y.); (H.M.J.); (T.A.K.)
| | - Cecilie Bæch-Laursen
- Department of Biomedical Sciences and Novo Nordisk Foundation, Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark; (C.B.-L.); (J.J.H.)
| | - Jens Juul Holst
- Department of Biomedical Sciences and Novo Nordisk Foundation, Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark; (C.B.-L.); (J.J.H.)
| | - Christoffer Laustsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus, Denmark;
| | - Mette Skou Hedemann
- Department of Animal and Veterinary Sciences, Aarhus University, Blichers Allé 20, DK-8830 Tjele, Denmark
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16
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Vaeggemose M, Schulte RF, Hansen ESS, Miller JJ, Rasmussen CW, Pilgrim-Morris JH, Stewart NJ, Collier GJ, Wild JM, Laustsen C. A Framework for Predicting X-Nuclei Transmitter Gain Using 1H Signal. Tomography 2023; 9:1603-1616. [PMID: 37736981 PMCID: PMC10514872 DOI: 10.3390/tomography9050128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/13/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023] Open
Abstract
Commercial human MR scanners are optimised for proton imaging, containing sophisticated prescan algorithms with setting parameters such as RF transmit gain and power. These are not optimal for X-nuclear application and are challenging to apply to hyperpolarised experiments, where the non-renewable magnetisation signal changes during the experiment. We hypothesised that, despite the complex and inherently nonlinear electrodynamic physics underlying coil loading and spatial variation, simple linear regression would be sufficient to accurately predict X-nuclear transmit gain based on concomitantly acquired data from the proton body coil. We collected data across 156 scan visits at two sites as part of ongoing studies investigating sodium, hyperpolarised carbon, and hyperpolarised xenon. We demonstrate that simple linear regression is able to accurately predict sodium, carbon, or xenon transmit gain as a function of position and proton gain, with variation that is less than the intrasubject variability. In conclusion, sites running multinuclear studies may be able to remove the time-consuming need to separately acquire X-nuclear reference power calibration, inferring it from the proton instead.
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Affiliation(s)
- Michael Vaeggemose
- GE HealthCare, 2605 Brondby, Denmark;
- MR Research Centre, Aarhus University, 8200 Aarhus, Denmark; (E.S.S.H.); (J.J.M.)
| | | | - Esben S. S. Hansen
- MR Research Centre, Aarhus University, 8200 Aarhus, Denmark; (E.S.S.H.); (J.J.M.)
| | - Jack J. Miller
- MR Research Centre, Aarhus University, 8200 Aarhus, Denmark; (E.S.S.H.); (J.J.M.)
| | - Camilla W. Rasmussen
- MR Research Centre, Aarhus University, 8200 Aarhus, Denmark; (E.S.S.H.); (J.J.M.)
| | - Jemima H. Pilgrim-Morris
- POLARIS Group, University of Sheffield, Sheffield S10 2TN, UK; (J.H.P.-M.); (N.J.S.); (G.J.C.); (J.M.W.)
| | - Neil J. Stewart
- POLARIS Group, University of Sheffield, Sheffield S10 2TN, UK; (J.H.P.-M.); (N.J.S.); (G.J.C.); (J.M.W.)
| | - Guilhem J. Collier
- POLARIS Group, University of Sheffield, Sheffield S10 2TN, UK; (J.H.P.-M.); (N.J.S.); (G.J.C.); (J.M.W.)
| | - Jim M. Wild
- POLARIS Group, University of Sheffield, Sheffield S10 2TN, UK; (J.H.P.-M.); (N.J.S.); (G.J.C.); (J.M.W.)
| | - Christoffer Laustsen
- MR Research Centre, Aarhus University, 8200 Aarhus, Denmark; (E.S.S.H.); (J.J.M.)
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17
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Gullaksen S, Vernstrøm L, Sørensen SS, Ringgaard S, Laustsen C, Funck KL, Poulsen PL, Laugesen E. Separate and combined effects of semaglutide and empagliflozin on kidney oxygenation and perfusion in people with type 2 diabetes: a randomised trial. Diabetologia 2023; 66:813-825. [PMID: 36746803 DOI: 10.1007/s00125-023-05876-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/30/2022] [Indexed: 02/08/2023]
Abstract
AIMS/HYPOTHESIS Glucagon-like peptide-1 receptor agonists (GLP-1ras) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) have shown kidney-protective effects. Improved kidney oxygenation and haemodynamic changes are suggested mechanisms; however, human data are scarce. We therefore investigated whether semaglutide (GLP-1ra), empagliflozin (SGLT2i) or their combination improve kidney oxygenation and perfusion. METHODS The trial was undertaken at Aarhus University Hospital, Denmark. A total of 120 people with type 2 diabetes (HbA1c ≥48 mmol/mol [6.5%]) and at high risk of CVD (age ≥50 years) were randomised into four parallel groups (n=30 in each group) for 32 weeks: 1.0 mg semaglutide (open label); 10 mg empagliflozin (blinded to participants, caregivers, examiners and outcome assessors); their combination (1.0 mg semaglutide open label plus 10 mg empagliflozin blinded to participants, caregivers, examiners and outcome assessors); and placebo tablet (blinded to participants, caregivers, examiners and outcome assessors). Sequentially numbered, sealed envelopes containing computer-generated randomisation codes, provided by Glostrup Pharmacy, Glostrup, Denmark, determined the intervention. The two co-primary outcomes were change in kidney oxygenation and change in arterial stiffness. This paper reports on kidney oxygenation, for which 80 individuals as prespecified, 20 in each group, underwent MRI. We primarily hypothesised that kidney oxygenation would be improved in the active treatment groups compared with placebo after 32 weeks. Secondary outcomes included changes in kidney perfusion, erythropoietin, haematocrit, urine albumin/creatinine ratio (UACR) and GFR (measured using technetium-99m) compared with baseline and between treatment groups at week 32. RESULTS Our model estimated a common baseline R2* value across all four groups in the cortex and the medulla. At baseline, the value was 24.5 (95% CI 23.9, 24.9) Hz in the medulla. After 32 weeks, the R2* values in the medulla were estimated to be 25.4 (95% CI 24.7, 26.2) Hz in the empagliflozin group and 24.5 (95% CI 23.9, 25.1) Hz in the placebo group (p=0.016) (higher R2* corresponds to a lower oxygenation). Semaglutide decreased perfusion in both the cortex and the medulla. Empagliflozin increased erythropoietin and haematocrit. All three active treatments decreased GFR but not UACR. Ten serious adverse events were reported, among them two occurrences of semaglutide-associated obstipation. CONCLUSIONS/INTERPRETATION Our hypothesis, that semaglutide, empagliflozin or their combination improve kidney oxygenation, was rejected. On the contrary, empagliflozin induced a reduction in medullary kidney oxygenation. Semaglutide substantially reduced kidney perfusion without affecting oxygenation. TRIAL REGISTRATION Clinicaltrialsregister.eu EudraCT 2019-000781-38 FUNDING: Novo Nordisk Foundation, Central Denmark Region Research Fund and Danish Medical Associations Research Foundation.
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Affiliation(s)
- Søren Gullaksen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
| | - Liv Vernstrøm
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Steffen S Sørensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Endocrinology and Internal Medicine, 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
| | - Kristian L Funck
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Per L Poulsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Esben Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
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Sejersen S, Rasmussen CW, Bøgh N, Kjaergaard U, Hansen ESS, Schulte RF, Laustsen C. Considering whole-body metabolism in hyperpolarized MRI through 13 C breath analysis-An alternative way to quantification and normalization? Magn Reson Med 2023; 90:664-672. [PMID: 37094025 DOI: 10.1002/mrm.29669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/12/2023] [Accepted: 03/27/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE Hyperpolarized [1-13 C]pyruvate MRI is an emerging clinical tool for metabolic imaging. It has the potential for absolute quantitative metabolic imaging. However, the method itself is not quantitative, limiting comparison of images across both time and between individuals. Here, we propose a simple signal normalization to the whole-body oxidative metabolism to overcome this limitation. THEORY AND METHODS A simple extension of the model-free ratiometric analysis of hyperpolarized [1-13 C]pyruvate MRI is presented, using the expired 13 CO2 in breath for normalization. The proposed framework was investigated in two porcine cohorts (N = 11) subjected to local renal hypoperfusion defects and subsequent [1-13 C]pyruvate MRI. A breath sample was taken before the [1-13 C]pyruvate injection and 5 min after. The raw MR signal from both the healthy and intervened kidney in the two cohorts was normalized using the 13 CO2 in the expired air. RESULTS 13 CO2 content in the expired air was significantly different between the two cohorts. Normalization to this reduced the coefficients of variance in the aerobic metabolic sensitive pathways by 25% for the alanine/pyruvate ratio, and numerical changes were observed in the bicarbonate/pyruvate ratio. The lactate/pyruvate ratio was largely unaltered (<2%). CONCLUSION Our results indicate that normalizing the hyperpolarized 13 C-signal ratios by the 13 CO2 content in expired air can reduce variation as well as improve specificity of the method by normalizing the metabolic readout to the overall metabolic status of the individual. The method is a simple and cheap extension to the hyperpolarized 13 C exam.
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Affiliation(s)
- Steffen Sejersen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Camilla W Rasmussen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Uffe Kjaergaard
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Esben S S Hansen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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19
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Kjærgaard U, Bøgh N, Hansen ESS, Tougaard RS, Bertelsen LB, Schulte RF, Laustsen C. Assessment of focal renal ischemia–reperfusion injury in a porcine model using hyperpolarized [
1‐
13
C
]pyruvate
MRI. Magn Reson Med 2023; 90:655-663. [DOI: 10.1002/mrm.29649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
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20
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Wang W, Sánchez-Heredia JD, Olin RB, Hansen ESS, Laustsen C, Zhurbenko V, Ardenkjaer-Larsen JH. A cryogenic 14-channel 13 C receiver array for 3T human head imaging. Magn Reson Med 2023; 89:1265-1277. [PMID: 36321576 PMCID: PMC10092528 DOI: 10.1002/mrm.29508] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/09/2022] [Accepted: 10/11/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE This article presents a novel 14-channel receive-only array for 13 C human head imaging at 3 T that explores the SNR gain by operating at cryogenic temperature cooled by liquid nitrogen. METHODS Cryostats are developed to evaluate single-coil bench SNR performance and cool the 14-channel array with liquid nitrogen while having enough thermal insulation between the coils and the sample. The temperature distribution for the coil array is measured. Circuits are adapted to the -189°C environment and implemented in the 14-channel array. 13 C images are acquired with the array at cryogenic and room temperature in a 3T scanner. RESULTS Compared with room temperature, the array at cryogenic temperature provides 27%-168% SNR improvement over all voxels and 47% SNR improvement near the image center. The measurements show a decrease of the element noise correlation at cryogenic temperature. CONCLUSION It is demonstrated that higher SNR can be achieved by cryogenically cooling the 14-channel array. A cryogenic array suitable for clinical imaging can be further developed on the array proposed. The cryogenic coil array is most likely suited for scenarios in which high SNR deep in a head and decent SNR on the periphery are required.
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Affiliation(s)
- Wenjun Wang
- National Space Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Rie Beck Olin
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Christoffer Laustsen
- MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Vitaliy Zhurbenko
- National Space Institute, Technical University of Denmark, Kongens Lyngby, Denmark
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21
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Sørensen SS, Gullaksen S, Vernstrøm L, Ringgaard S, Laustsen C, Funck KL, Laugesen E, Poulsen PL. Evaluation of renal oxygenation by BOLD-MRI in high-risk patients with type 2 diabetes and matched controls. Nephrol Dial Transplant 2023; 38:691-699. [PMID: 35612982 DOI: 10.1093/ndt/gfac186] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Diabetic kidney disease (DKD) accounts for ∼50% of end-stage kidney disease. Renal hypoxia is suggested as a main driver in the pathophysiology underlying chronic DKD. Blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) has made noninvasive investigations of renal oxygenation in humans possible. Whether diabetes per se contributes to measurable changes in renal oxygenation by BOLD-MRI remains to be elucidated. We investigated whether renal oxygenation measured with BOLD-MRI differs between people with type 2 diabetes (T2DM) with normal to moderate chronic kidney disease (CKD) (Stages 1-3A) and matched controls. The repeatability of the BOLD-MRI method was also assessed. METHODS In this matched cross-sectional study, 20 people with T2DM (age 69.2 ± 4.7 years, duration of diabetes 10.5 ± 6.7 years, male 55.6%) and 20 matched nondiabetic controls (mean age 68.8 ± 5.4 years, male 55.%) underwent BOLD-MRI analysed with the 12-layer concentric object method (TLCO). To investigate the repeatability, seven in the T2DM group and nine in the control group were scanned twice. RESULTS A significant reduction in renal oxygenation from the cortex to medulla was found in both groups (P < .01) but no intergroup difference was detected [0.71/s (95% confidence interval -0.28-1.7), P = .16]. The median intraindividual coefficient of variation (CV) varied from 1.2% to 7.0%. CONCLUSION T2DM patients with normal to moderate CKD do not seem to have lower renal oxygenation when measured with BOLD-MRI and TLCO. BOLD-MRI has a low intraindividual CV and seems like a reliable method for investigation of renal oxygenation in T2DM.
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Affiliation(s)
- Steffen S Sørensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark
| | - Søren Gullaksen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark
| | - Liv Vernstrøm
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Kristian L Funck
- Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark
| | - Esben Laugesen
- Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark
| | - Per L Poulsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Steno Diabetes Center, Aarhus University Hospital, Aarhus, Denmark
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Lildal SK, Hansen ESS, Laustsen C, Nørregaard R, Bertelsen LB, Madsen K, Rasmussen CW, Osther PJS, Jung H. Gadolinium-enhanced MRI visualizing backflow at increasing intra-renal pressure in a porcine model. PLoS One 2023; 18:e0281676. [PMID: 36795705 PMCID: PMC9934347 DOI: 10.1371/journal.pone.0281676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION Intrarenal backflow (IRB) is known to occur at increased intrarenal pressure (IRP). Irrigation during ureteroscopy increases IRP. Complications such as sepsis is more frequent after prolonged high-pressure ureteroscopy. We evaluated a new method to document and visualize intrarenal backflow as a function of IRP and time in a pig model. METHODS Studies were performed on five female pigs. A ureteral catheter was placed in the renal pelvis and connected to a Gadolinium/ saline solution 3 ml/L for irrigation. An occlusion balloon-catheter was left inflated at the uretero-pelvic junction and connected to a pressure monitor. Irrigation was successively regulated to maintain steady IRP levels at 10, 20, 30, 40 and 50 mmHg. MRI of the kidneys was performed at 5-minute intervals. PCR and immunoassay analyses were executed on the harvested kidneys to detect potential changes in inflammatory markers. RESULTS MRI showed backflow of Gadolinium into the kidney cortex in all cases. The mean time to first visual damage was 15 minutes and the mean registered pressure at first visual damage was 21 mmHg. On the final MRI the mean percentage of IRB affected kidney was 66% after irrigation with a mean maximum pressure of 43 mmHg for a mean duration of 70 minutes. Immunoassay analyses showed increased MCP-1 mRNA expression in the treated kidneys compared to contralateral control kidneys. CONCLUSIONS Gadolinium enhanced MRI provided detailed information about IRB that has not previously been documented. IRB occurs at even very low pressures, and these findings are in conflict with the general consensus that keeping IRP below 30-35 mmHg eliminates the risk of post-operative infection and sepsis. Moreover, the level of IRB was documented to be a function of both IRP and time. The results of this study emphasize the importance of keeping IRP and OR time low during ureteroscopy.
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Affiliation(s)
| | | | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Rikke Nørregaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Bonde Bertelsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kirsten Madsen
- Department of Clinical Pathology, Odense University Hospital, Odense, Denmark
| | - Camilla W. Rasmussen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Palle Jörn Sloth Osther
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Urology, Vejle Hospital–a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Helene Jung
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Urology, Vejle Hospital–a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
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23
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Rasmussen CW, Bøgh N, Bech SK, Thorsen TH, Hansen ESS, Bertelsen LB, Laustsen C. Fibrosis imaging with multiparametric proton and sodium MRI in pig injury models. NMR Biomed 2023; 36:e4838. [PMID: 36151711 PMCID: PMC10078455 DOI: 10.1002/nbm.4838] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 05/10/2023]
Abstract
Chronic kidney disease (CKD) is common and has huge implications for health and mortality. It is aggravated by intrarenal fibrosis, but the assessment of fibrosis is limited to kidney biopsies, which carry a risk of complications and sampling errors. This calls for a noninvasive modality for diagnosing and staging intrarenal fibrosis. The current, exploratory study evaluates a multiparametric MRI protocol including sodium imaging (23 Na-MRI) to determine the opportunities within this modality to assess kidney injury as a surrogate endpoint of fibrosis. The study includes 43 pigs exposed to ischemia-reperfusion injury (IRI) or unilateral ureteral obstruction (UUO), or serving as healthy controls. Fibrosis was determined using gene expression analysis of collagen. The medulla/cortex ratio of 23 Na-MRI decreased in the injured kidney in the IRI pigs, but not in the UUO pigs (p = 0.0180, p = 0.0754). To assess the combination of MRI parameters in estimating fibrosis, we created a linear regression model consisting of the cortical apparent diffusion coefficient, ΔR2*, ΔT1, the 23 Na medulla/cortex ratio, and plasma creatinine (R2 = 0.8009, p = 0.0117). The 23 Na medulla/cortex ratio only slightly improved the fibrosis prediction model, leaving 23 Na-MRI in an ambiguous place for evaluation of intrarenal fibrosis. Use of multiparametric MRI in combination with plasma creatinine shows potential for the estimation of fibrosis in human kidney disease, but more translational and clinical work is warranted before MRI can contribute to earlier diagnosis and evaluation of treatment for acute kidney injury and CKD.
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Affiliation(s)
- Camilla W. Rasmussen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Sabrina K. Bech
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Thomas H. Thorsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Esben S. S. Hansen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Lotte B. Bertelsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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24
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Vaeggemose M, Schulte RF, Laustsen C. Clinically feasible B 1 field correction for multi-organ sodium imaging at 3 T. NMR Biomed 2023; 36:e4835. [PMID: 36115017 PMCID: PMC10078323 DOI: 10.1002/nbm.4835] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 06/15/2023]
Abstract
Sodium MRI allows the non-invasive quantification of intra-organ sodium concentration. RF inhomogeneity introduces uncertainty in this estimated concentration. B1 field corrections can be used to overcome some of these limitations. However, the low signal-to-noise ratio in sodium MRI makes accurate B1 mapping in reasonable scan times challenging. The study aims to evaluate Bloch-Siegert off-resonance (BLOSI) B1 field correction for sodium MRI using a 3D Fermat looped, orthogonally encoded trajectories (FLORET) read-out trajectory. We propose a clinically feasible B1 field map correction method for sodium imaging at 3 T, evaluating five healthy subjects' brain, heart blood, kidneys, and thigh muscle. We scanned the subjects twice for repeatability measures and used sodium phantoms to determine organ total sodium concentration. Conventional proton scans were compared with sodium images for organ structural integrity. The BLOSI approach based on the 3D FLORET read-out trajectory was used in B1 field correction and 3D density-adapted radial acquisition for sodium imaging. Results indicate improvements in sodium imaging based on B1 field correction in a clinically feasible protocol. Improvements are determined in all organs by enhanced anatomical representation, organ homogeneity, and an increase in the total sodium concentration after applying a B1 field correction. The proposed BLOSI-based B1 field correction using a 3D FLORET read-out trajectory is clinically feasible for sodium imaging, which is shown in the brain, heart, kidney, and thigh muscle. This supports using fast B1 field mapping in the clinical setting.
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Affiliation(s)
- Michael Vaeggemose
- GE HealthcareBrondbyDenmark
- MR Research Centre, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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25
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Grist JT, Bøgh N, Hansen ES, Schneider AM, Healicon R, Ball V, Miller JJJJ, Smart S, Couch Y, Buchan AM, Tyler DJ, Laustsen C. Developing a metabolic clearance rate framework as a translational analysis approach for hyperpolarized 13C magnetic resonance imaging. Sci Rep 2023; 13:1613. [PMID: 36709217 PMCID: PMC9884306 DOI: 10.1038/s41598-023-28643-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/23/2023] [Indexed: 01/29/2023] Open
Abstract
Hyperpolarized carbon-13 magnetic resonance imaging is a promising technique for in vivo metabolic interrogation of alterations between health and disease. This study introduces a formalism for quantifying the metabolic information in hyperpolarized imaging. This study investigated a novel perfusion formalism and metabolic clearance rate (MCR) model in pre-clinical stroke and in the healthy human brain. Simulations showed that the proposed model was robust to perturbations in T1, transmit B1, and kPL. A significant difference in ipsilateral vs contralateral pyruvate derived cerebral blood flow (CBF) was detected in rats (140 ± 2 vs 89 ± 6 mL/100 g/min, p < 0.01, respectively) and pigs (139 ± 12 vs 95 ± 5 mL/100 g/min, p = 0.04, respectively), along with an increase in fractional metabolism (26 ± 5 vs 4 ± 2%, p < 0.01, respectively) in the rodent brain. In addition, a significant increase in ipsilateral vs contralateral MCR (0.034 ± 0.007 vs 0.017 ± 0.02/s, p = 0.03, respectively) and a decrease in mean transit time (31 ± 8 vs 60 ± 2 s, p = 0.04, respectively) was observed in the porcine brain. In conclusion, MCR mapping is a simple and robust approach to the post-processing of hyperpolarized magnetic resonance imaging.
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Affiliation(s)
- James T Grist
- Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, UK
- Division of Cardiovascular Medicine, Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK
- Department of Radiology, Oxford University Hospitals Trust, Oxford, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Nikolaj Bøgh
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Esben Søvsø Hansen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Anna M Schneider
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Richard Healicon
- Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, UK
| | - Vicky Ball
- Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, UK
| | - Jack J J J Miller
- Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, UK
- Division of Cardiovascular Medicine, Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Sean Smart
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Yvonne Couch
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | | | - Damian J Tyler
- Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, UK
- Division of Cardiovascular Medicine, Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark.
- Aarhus University Hospital, MR Center, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
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Schutter R, van Varsseveld OC, Lantinga VA, Pool MBF, Hamelink TH, Potze JH, Leuvenink HGD, Laustsen C, Borra RJH, Moers C. Magnetic resonance imaging during warm ex vivo kidney perfusion. Artif Organs 2023; 47:105-116. [PMID: 35996889 PMCID: PMC10086841 DOI: 10.1111/aor.14391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/30/2022] [Accepted: 08/02/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The shortage of donor organs for transplantation remains a worldwide problem. The utilization of suboptimal deceased donors enlarges the pool of potential organs, yet consequently, clinicians face the difficult decision of whether these sub-optimal organs are of sufficient quality for transplantation. Novel technologies could play a pivotal role in making pre-transplant organ assessment more objective and reliable. METHODS Ex vivo normothermic machine perfusion (NMP) at temperatures around 35-37°C allows organ quality assessment in a near-physiological environment. Advanced magnetic resonance imaging (MRI) techniques convey unique information about an organ's structural and functional integrity. The concept of applying magnetic resonance imaging during renal normothermic machine perfusion is novel in both renal and radiological research and we have developed the first MRI-compatible NMP setup for human-sized kidneys. RESULTS We were able to obtain a detailed and real-time view of ongoing processes inside renal grafts during ex vivo perfusion. This new technique can visualize structural abnormalities, quantify regional flow distribution, renal metabolism, and local oxygen availability, and track the distribution of ex vivo administered cellular therapy. CONCLUSION This platform allows for advanced pre-transplant organ assessment, provides a new realistic tool for studies into renal physiology and metabolism, and may facilitate therapeutic tracing of pharmacological and cellular interventions to an isolated kidney.
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Affiliation(s)
- Rianne Schutter
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Otis C van Varsseveld
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Veerle A Lantinga
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Merel B F Pool
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tim H Hamelink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan Hendrik Potze
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henri G D Leuvenink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Christoffer Laustsen
- Department of Clinical Medicine, The MR Research Center, Aarhus University, Aarhus, Denmark
| | - Ronald J H Borra
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cyril Moers
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Bøgh N, Grist JT, Rasmussen CW, Bertelsen LB, Hansen ESS, Blicher JU, Tyler DJ, Laustsen C. Lactate saturation limits bicarbonate detection in hyperpolarized 13 C-pyruvate MRI of the brain. Magn Reson Med 2022; 88:1170-1179. [PMID: 35533254 PMCID: PMC9322338 DOI: 10.1002/mrm.29290] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/22/2022] [Accepted: 04/15/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate the potential effects of [1-13 C]lactate RF saturation pulses on [13 C]bicarbonate detection in hyperpolarized [1-13 C]pyruvate MRI of the brain. METHODS Thirteen healthy rats underwent MRI with hyperpolarized [1-13 C]pyruvate of either the brain (n = 8) or the kidneys, heart, and liver (n = 5). Dynamic, metabolite-selective imaging was used in a cross-over experiment in which [1-13 C]lactate was excited with either 0° or 90° flip angles. The [13 C]bicarbonate SNR and apparent [1-13 C]pyruvate-to-[13 C]bicarbonate conversion (kPB ) were determined. Furthermore, simulations were performed to identify the SNR optimal flip-angle scheme for detection of [1-13 C]lactate and [13 C]bicarbonate. RESULTS In the brain, the [13 C]bicarbonate SNR was 64% higher when [1-13 C]lactate was not excited (5.8 ± 1.5 vs 3.6 ± 1.3; 1.2 to 3.3-point increase; p = 0.0027). The apparent kPB decreased 25% with [1-13 C]lactate saturation (0.0047 ± 0.0008 s-1 vs 0.0034 ± 0.0006 s-1 ; 95% confidence interval, 0.0006-0.0019 s-1 increase; p = 0.0049). These effects were not present in the kidneys, heart, or liver. Simulations suggest that the optimal [13 C]bicarbonate SNR with a TR of 1 s in the brain is obtained with [13 C]bicarbonate, [1-13 C]lactate, and [1-13 C]pyruvate flip angles of 60°, 15°, and 10°, respectively. CONCLUSIONS Radiofrequency saturation pulses on [1-13 C]lactate limit [13 C]bicarbonate detection in the brain specifically, which could be due to shuttling of lactate from astrocytes to neurons. Our results have important implications for experimental design in studies in which [13 C]bicarbonate detection is warranted.
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Affiliation(s)
- Nikolaj Bøgh
- MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - James T. Grist
- Department of Physiology, Anatomy, and GeneticsUniversity of OxfordOxfordUK
- Oxford Center for Clinical Magnetic Resonance ResearchUniversity of OxfordOxfordUK
- Department of RadiologyOxford University HospitalsOxfordUK
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Camilla W. Rasmussen
- MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Lotte B. Bertelsen
- MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Esben S. S. Hansen
- MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Jakob U. Blicher
- Center for Functionally Integrative NeuroscienceAarhus UniversityAarhusDenmark
- Department of NeurologyAalborg University HospitalAalborgDenmark
| | - Damian J. Tyler
- Department of Physiology, Anatomy, and GeneticsUniversity of OxfordOxfordUK
- Oxford Center for Clinical Magnetic Resonance ResearchUniversity of OxfordOxfordUK
| | - Christoffer Laustsen
- MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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28
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Sanchez‐Heredia JD, Olin RB, Grist JT, Wang W, Bøgh N, Zhurbenko V, Hansen ES, Schulte RF, Tyler D, Laustsen C, Ardenkjær‐Larsen JH. RF coil design for accurate parallel imaging on 13 C MRSI using 23 Na sensitivity profiles. Magn Reson Med 2022; 88:1391-1405. [PMID: 35635156 PMCID: PMC9328386 DOI: 10.1002/mrm.29259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/14/2022] [Accepted: 03/14/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To develop a coil-based method to obtain accurate sensitivity profiles in 13 C MRI at 3T from the endogenous 23 Na. An eight-channel array is designed for 13 C MR acquisitions. As application examples, the array is used for two-fold accelerated acquisitions of both hyperpolarized 13 C metabolic imaging of pig kidneys and the human brain. METHODS A flexible coil array was tuned optimally for 13 C at 3T (32.1 MHz), with the coil coupling coefficients matched to be nearly identical at the resonance frequency of 23 Na (33.8 MHz). This is done by enforcing a high decoupling (obtained through highly mismatched preamplifiers) and adjusting the coupling frequency response. The SNR performance is compared to reference coils. RESULTS The measured sensitivity profiles on a phantom showed high spatial similarity for 13 C and 23 Na resonances, with average noise correlation of 9 and 11%, respectively. For acceleration factors 2, 3, and 4, the obtained maximum g-factors were 1.0, 1.1, and 2.6, respectively. The 23 Na profiles obtained in vivo could be used successfully to perform two-fold acceleration of hyperpolarized 13 C 3D acquisitions of both pig kidneys and a healthy human brain. CONCLUSION A receive array has been developed in such a way that the 13 C sensitivity profiles could be accurately obtained from measurements at the 23 Na frequency. This technique facilitates accelerated acquisitions for hyperpolarized 13 C imaging. The SNR performance obtained at the 13 C frequency, compares well to other state-of-the-art coils for the same purpose, showing slightly better superficial and central SNR.
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Affiliation(s)
| | - Rie B. Olin
- Department of Health TechnologyTechnical University of DenmarkKgs. LyngbyDenmark
| | - James T. Grist
- Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
- Oxford Centre for Clinical Magnetic Resonance ResearchUniversity of OxfordOxfordUK
- Department of RadiologyOxford University Hospitals TrustOxfordUK
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Wenjun Wang
- National Space InstituteTechnical University of DenmarkKgs. LyngbyDenmark
| | - Nikolaj Bøgh
- MR Research Centre, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Vitaliy Zhurbenko
- National Space InstituteTechnical University of DenmarkKgs. LyngbyDenmark
| | - Esben S. Hansen
- MR Research Centre, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | | | - Damian Tyler
- Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
- Oxford Centre for Clinical Magnetic Resonance ResearchUniversity of OxfordOxfordUK
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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29
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Lildal S, Hansen E, Laustsen C, Osther P, Jung H. Intrarenal backflow during endoluminal irrigation visualized by dynamic Gadolinium-enhanced MRI. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00770-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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30
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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31
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Hansen ESS, Bertelsen LB, Bøgh N, Miller J, Wohlfart P, Ringgaard S, Laustsen C. Concentration-dependent effects of dichloroacetate in type 2 diabetic hearts assessed by hyperpolarized [1- 13 C]-pyruvate magnetic resonance imaging. NMR Biomed 2022; 35:e4678. [PMID: 34961990 DOI: 10.1002/nbm.4678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
Personalized medicine or individualized therapy promises a paradigm shift in healthcare. This is particularly true in complex and multifactorial diseases such as diabetes and the multitude of related pathophysiological complications. Diabetic cardiomyopathy represents an emerging condition that could be effectively treated if better diagnostic and, in particular, better therapeutic monitoring tools were available. In this study, we investigate the ability to differentiate low and high doses of metabolically targeted therapy in an obese type 2 diabetic rat model. Low-dose dichloroacetate (DCA) treatment was associated with increased lactate production, while no or little change was seen in bicarbonate production. High-dose DCA treatment was associated with a significant metabolic switch towards increased bicarbonate production. These findings support further studies using hyperpolarized [1-13 C]-pyruvate magnetic resonance imaging to differentiate treatment effects and thus allow for personalized titration of therapeutics.
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Affiliation(s)
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nikolaj Bøgh
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jack Miller
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- PET 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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Wood G, Kirkevang TS, Agergaard J, Leth S, Hansen ESS, Laustsen C, Larsen AH, Jensen HK, Østergaard LJ, Bøtker HE, Poulsen SH, Kim WY. Cardiac Performance and Cardiopulmonary Fitness After Infection With SARS-CoV-2. Front Cardiovasc Med 2022; 9:871603. [PMID: 35647079 PMCID: PMC9136046 DOI: 10.3389/fcvm.2022.871603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/15/2022] [Indexed: 01/04/2023] Open
Abstract
AimsPersistent cardiac symptoms are an increasingly reported phenomenon following COVID-19. However, the underlying cause of cardiac symptoms is unknown. This study aimed to identify the underlying causes, if any, of these symptoms 1 year following acute COVID-19 infection.Methods and Results22 individuals with persistent cardiac symptoms were prospectively investigated using echocardiography, cardiovascular magnetic resonance (CMR), 6-min walking test, cardio-pulmonary exercise testing and electrocardiography. A median of 382 days (IQR 368, 442) passed between diagnosis of COVID-19 and investigation. As a cohort their echocardiography, CMR, 6-min walking test and exercise testing results were within the normal ranges. There were no differences in left ventricular ejection fraction (61.45 ± 6.59 %), global longitudinal strain (19.80 ± 3.12 %) or tricuspid annular plane systolic excursion (24.96 ± 5.55 mm) as measured by echocardiography compared to a healthy control group. VO2 max (2045.00 ± 658.40 ml/min), % expected VO2 max (114.80 ± 23.08 %) and 6-minute distance walked (608.90 ± 54.51 m) exceeded that expected for the patient cohort, whilst Troponin I (5.59 ± 6.59 ng/l) and Nt-proBNP (88.18 ± 54.27 ng/l) were normal.ConclusionAmong a cohort of 22 patients with self-reported persistent cardiac symptoms, we identified no underlying cardiac disease or reduced cardiopulmonary fitness 1 year following COVID-19.
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Affiliation(s)
- Gregory Wood
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- *Correspondence: Gregory Wood
| | - Therese Stegeager Kirkevang
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jane Agergaard
- Department of Infectious Disease, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steffen Leth
- Department of Infectious Disease, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Internal Medicine, Gødstrup Hospital, Herning, Denmark
| | | | - Christoffer Laustsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anders Hostrup Larsen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henrik Kjærulf Jensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lars Jørgen Østergaard
- Department of Infectious Disease, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steen Hvitfeldt Poulsen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Won Yong Kim
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Ye Z, Song B, Lee PM, Ohliger MA, Laustsen C. Hyperpolarized carbon 13 MRI in liver diseases: Recent advances and future opportunities. Liver Int 2022; 42:973-983. [PMID: 35230742 PMCID: PMC9313895 DOI: 10.1111/liv.15222] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/20/2022] [Accepted: 02/04/2022] [Indexed: 02/05/2023]
Abstract
Hyperpolarized carbon-13 magnetic resonance imaging (HP 13 C MRI) is a recently translated metabolic imaging technique. With dissolution dynamic nuclear polarization (d-DNP), more than 10 000-fold signal enhancement can be readily reached, making it possible to visualize real-time metabolism and specific substrate-to-metabolite conversions in the liver after injecting carbon-13 labelled probes. Increasing evidence suggests that HP 13 C MRI is a potential tool in detecting liver abnormalities, predicting disease progression and monitoring response treatment. In this review, we will introduce the recent progresses of HP 13 C MRI in diffuse liver diseases and liver malignancies and discuss its future opportunities from a clinical perspective, hoping to provide a comprehensive overview of this novel technique in liver diseases and highlight its scientific and clinical potential in the field of hepatology.
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Affiliation(s)
- Zheng Ye
- Department of RadiologyWest China Hospital, Sichuan UniversityChengduSichuanChina
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Bin Song
- Department of RadiologyWest China Hospital, Sichuan UniversityChengduSichuanChina
| | - Philip M. Lee
- Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Michael A. Ohliger
- Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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34
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Hansen K, Hansen ESS, Jespersen NRV, Bøtker HE, Pedersen M, Wang T, Laustsen C. Hyperpolarized
13
C
MRI Reveals Large Changes in Pyruvate Metabolism During Digestion in Snakes. Magn Reson Med 2022; 88:890-900. [PMID: 35426467 PMCID: PMC9321735 DOI: 10.1002/mrm.29239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/31/2022] [Accepted: 02/25/2022] [Indexed: 11/05/2022]
Abstract
Purpose Methods Results Conclusion
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Affiliation(s)
- Kasper Hansen
- Comparative Medicine Lab, Department of Clinical Medicine Aarhus University Aarhus Denmark
- Zoophysiology, Department of Biology Aarhus University Aarhus Denmark
- Department of Forensic Medicine Aarhus University Aarhus Denmark
| | | | | | - Hans Erik Bøtker
- Cardiology, Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Michael Pedersen
- Comparative Medicine Lab, Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Tobias Wang
- Zoophysiology, Department of Biology Aarhus University Aarhus Denmark
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine Aarhus University Aarhus Denmark
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35
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Staehr C, Rohde PD, Krarup NT, Ringgaard S, Laustsen C, Johnsen J, Nielsen R, Beck HC, Morth JP, Lykke-Hartmann K, Jespersen NR, Abramochkin D, Nyegaard M, Bøtker HE, Aalkjaer C, Matchkov V. Migraine-Associated Mutation in the Na,K-ATPase Leads to Disturbances in Cardiac Metabolism and Reduced Cardiac Function. J Am Heart Assoc 2022; 11:e021814. [PMID: 35289188 PMCID: PMC9075430 DOI: 10.1161/jaha.121.021814] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Mutations in ATP1A2 gene encoding the Na,K‐ATPase α2 isoform are associated with familial hemiplegic migraine type 2. Migraine with aura is a known risk factor for heart disease. The Na,K‐ATPase is important for cardiac function, but its role for heart disease remains unknown. We hypothesized that ATP1A2 is a susceptibility gene for heart disease and aimed to assess the underlying disease mechanism. Methods and Results Mice heterozygous for the familial hemiplegic migraine type 2–associated G301R mutation in the Atp1a2 gene (α2+/G301R mice) and matching wild‐type controls were compared. Reduced expression of the Na,K‐ATPase α2 isoform and increased expression of the α1 isoform were observed in hearts from α2+/G301R mice (Western blot). Left ventricular dilation and reduced ejection fraction were shown in hearts from 8‐month‐old α2+/G301R mice (cardiac magnetic resonance imaging), and this was associated with reduced nocturnal blood pressure (radiotelemetry). Cardiac function and blood pressure of 3‐month‐old α2+/G301R mice were similar to wild‐type mice. Amplified Na,K‐ATPase–dependent Src kinase/Ras/Erk1/2 (p44/42 mitogen‐activated protein kinase) signaling was observed in hearts from 8‐month‐old α2+/G301R mice, and this was associated with mitochondrial uncoupling (respirometry), increased oxidative stress (malondialdehyde measurements), and a heart failure–associated metabolic shift (hyperpolarized magnetic resonance). Mitochondrial membrane potential (5,5´,6,6´‐tetrachloro‐1,1´,3,3´‐tetraethylbenzimidazolocarbocyanine iodide dye assay) and mitochondrial ultrastructure (transmission electron microscopy) were similar between the groups. Proteomics of heart tissue further suggested amplified Src/Ras/Erk1/2 signaling and increased oxidative stress and provided the molecular basis for systolic dysfunction in 8‐month‐old α2+/G301R mice. Conclusions Our findings suggest that ATP1A2 mutation leads to disturbed cardiac metabolism and reduced cardiac function mediated via Na,K‐ATPase–dependent reactive oxygen species signaling through the Src/Ras/Erk1/2 pathway.
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Affiliation(s)
- Christian Staehr
- Department of Biomedicine, Health Aarhus University Aarhus Denmark
| | - Palle Duun Rohde
- Department of Chemistry and Bioscience Aalborg University Aalborg 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
| | - Jacob Johnsen
- Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Rikke Nielsen
- Department of Biomedicine, Health Aarhus University Aarhus Denmark
| | - Hans Christian Beck
- Department for Clinical Biochemistry and Pharmacology Odense University Hospital Odense Denmark
| | - Jens Preben Morth
- Department of Biotechnology and Biomedicine Technical University of Denmark Kgs. Lyngby Denmark
| | - Karin Lykke-Hartmann
- Department of Biomedicine, Health Aarhus University Aarhus Denmark.,Department of Clinical Medicine Aarhus University Aarhus Denmark.,Department of Clinical Genetics Aarhus University Hospital Aarhus Denmark
| | | | - Denis Abramochkin
- Department of Human and Animal Physiology Biological Faculty Lomonosov Moscow State University Moscow Russia
| | - Mette Nyegaard
- Department of Biomedicine, Health Aarhus University Aarhus Denmark.,Department of Health Science and Technology Aalborg University Aalborg Denmark
| | - Hans Erik Bøtker
- Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Christian Aalkjaer
- Department of Biomedicine, Health Aarhus University Aarhus Denmark.,Department of Biomedical Sciences Copenhagen University Copenhagen Denmark
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Laustsen C, Bøgh N. Sodium MRI of the Renal Corticomedullary Gradient. Radiology 2022; 303:390-391. [PMID: 35133202 DOI: 10.1148/radiol.213007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Christoffer Laustsen
- From the MR Research Center, Department of Clinical Medicine, Aarhus University, Palle Juul Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Nikolaj Bøgh
- From the MR Research Center, Department of Clinical Medicine, Aarhus University, Palle Juul Jensens Boulevard 99, 8200 Aarhus, Denmark
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37
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de Boer A, Villa G, Bane O, Bock M, Cox EF, Dekkers IA, Eckerbom P, Fernández‐Seara MA, Francis ST, Haddock B, Hall ME, Hall Barrientos P, Hermann I, Hockings PD, Lamb HJ, Laustsen C, Lim RP, Morris DM, Ringgaard S, Serai SD, Sharma K, Sourbron S, Takehara Y, Wentland AL, Wolf M, Zöllner FG, Nery F, Caroli A. Consensus-Based Technical Recommendations for Clinical Translation of Renal Phase Contrast MRI. J Magn Reson Imaging 2022; 55:323-335. [PMID: 33140551 PMCID: PMC9291014 DOI: 10.1002/jmri.27419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Phase-contrast (PC) MRI is a feasible and valid noninvasive technique to measure renal artery blood flow, showing potential to support diagnosis and monitoring of renal diseases. However, the variability in measured renal blood flow values across studies is large, most likely due to differences in PC-MRI acquisition and processing. Standardized acquisition and processing protocols are therefore needed to minimize this variability and maximize the potential of renal PC-MRI as a clinically useful tool. PURPOSE To build technical recommendations for the acquisition, processing, and analysis of renal 2D PC-MRI data in human subjects to promote standardization of renal blood flow measurements and facilitate the comparability of results across scanners and in multicenter clinical studies. STUDY TYPE Systematic consensus process using a modified Delphi method. POPULATION Not applicable. SEQUENCE FIELD/STRENGTH Renal fast gradient echo-based 2D PC-MRI. ASSESSMENT An international panel of 27 experts from Europe, the USA, Australia, and Japan with 6 (interquartile range 4-10) years of experience in 2D PC-MRI formulated consensus statements on renal 2D PC-MRI in two rounds of surveys. Starting from a recently published systematic review article, literature-based and data-driven statements regarding patient preparation, hardware, acquisition protocol, analysis steps, and data reporting were formulated. STATISTICAL TESTS Consensus was defined as ≥75% unanimity in response, and a clear preference was defined as 60-74% agreement among the experts. RESULTS Among 60 statements, 57 (95%) achieved consensus after the second-round survey, while the remaining three showed a clear preference. Consensus statements resulted in specific recommendations for subject preparation, 2D renal PC-MRI data acquisition, processing, and reporting. DATA CONCLUSION These recommendations might promote a widespread adoption of renal PC-MRI, and may help foster the set-up of multicenter studies aimed at defining reference values and building larger and more definitive evidence, and will facilitate clinical translation of PC-MRI. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Anneloes de Boer
- Department of RadiologyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Giulia Villa
- Department of BioengineeringIstituto di Ricerche Farmacologiche Mario Negri IRCCSBergamoItaly
| | - Octavia Bane
- Biomedical Engineering and Imaging Institute/RadiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Michael Bock
- Department of Radiology ‐ Medical Physics, Medical CenterUniversity of Freiburg, Faculty of Medicine, University of FreiburgFreiburgGermany
| | - Eleanor F. Cox
- Sir Peter Mansfield Imaging Centre, School of Physics and AstronomyUniversity of NottinghamNottinghamUK
| | - Ilona A. Dekkers
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Per Eckerbom
- Department of Surgical SciencesUppsala UniversityUppsalaSweden
| | | | - Susan T. Francis
- Sir Peter Mansfield Imaging Centre, School of Physics and AstronomyUniversity of NottinghamNottinghamUK
| | - Bryan Haddock
- Department of Clinical Physiology, Nuclear Medicine and PET, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Michael E. Hall
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | | | - Ingo Hermann
- Computer Assisted Clinical Medicine, Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
| | | | - Hildo J. Lamb
- Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Christoffer Laustsen
- Department of Clinical Medicine, MR Research CentreAarhus UniversityAarhusDenmark
| | - Ruth P. Lim
- Departments of Radiology, Surgery and MedicineThe University of MelbourneParkvilleVictoriaAustralia
- Department of RadiologyAustin HealthHeidelbergVictoriaAustralia
| | - David M. Morris
- Centre for Inflammation ResearchUniversity of Edinburgh, Edinburgh BioquarterEdinburghUK
| | - Steffen Ringgaard
- Department of Clinical Medicine, MR Research CentreAarhus UniversityAarhusDenmark
| | - Suraj D. Serai
- Department of RadiologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Kanishka Sharma
- Department of Imaging, Infection, Immunity and Cardiovascular DiseaseThe University of SheffieldSheffieldUK
| | - Steven Sourbron
- Department of Imaging, Infection, Immunity and Cardiovascular DiseaseThe University of SheffieldSheffieldUK
| | - Yasuo Takehara
- Department of Fundamental Development for Advanced Low Invasive Diagnostic ImagingNagoya University, Graduate School of MedicineNagoyaJapan
| | | | - Marcos Wolf
- High Field MR Center, Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
| | - Frank G. Zöllner
- Computer Assisted Clinical Medicine, Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
| | - Fabio Nery
- Developmental Imaging and Biophysics SectionUCL Great Ormond Street Institute of Child HealthLondonUK
| | - Anna Caroli
- Department of BioengineeringIstituto di Ricerche Farmacologiche Mario Negri IRCCSBergamoItaly
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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: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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39
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Bøgh N, Olin RB, Hansen ESS, Gordon JW, Bech SK, Bertelsen LB, Sánchez-Heredia JD, Blicher JU, Østergaard L, Ardenkjær-Larsen JH, Bok RA, Vigneron DB, Laustsen C. Metabolic MRI with hyperpolarized [1- 13C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke. J Cereb Blood Flow Metab 2021; 41:2916-2927. [PMID: 34013807 PMCID: PMC8756460 DOI: 10.1177/0271678x211018317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 01/17/2023]
Abstract
Acute ischemic stroke patients benefit from reperfusion in a short time-window after debut. Later treatment may be indicated if viable brain tissue is demonstrated and this outweighs the inherent risks of late reperfusion. Magnetic resonance imaging (MRI) with hyperpolarized [1-13C]pyruvate is an emerging technology that directly images metabolism. Here, we investigated its potential to detect viable tissue in ischemic stroke. Stroke was induced in pigs by intracerebral injection of endothelin 1. During ischemia, the rate constant of pyruvate-to-lactate conversion, kPL, was 52% larger in penumbra and 85% larger in the infarct compared to the contralateral hemisphere (P = 0.0001). Within the penumbra, the kPL was 50% higher in the regions that later infarcted compared to non-progressing regions (P = 0.026). After reperfusion, measures of pyruvate-to-lactate conversion were slightly decreased in the infarct compared to contralateral. In addition to metabolic imaging, we used hyperpolarized pyruvate for perfusion-weighted imaging. This was consistent with conventional imaging for assessment of infarct size and blood flow. Lastly, we confirmed the translatability of simultaneous assessment of metabolism and perfusion with hyperpolarized MRI in healthy volunteers. In conclusion, hyperpolarized [1-13C]pyruvate may aid penumbral characterization and increase access to reperfusion therapy for late presenting patients.
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Affiliation(s)
- Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Rie B Olin
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Esben SS Hansen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA
| | - Sabrina K Bech
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte B Bertelsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Juan D Sánchez-Heredia
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Jakob U Blicher
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Leif Østergaard
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Jan H Ardenkjær-Larsen
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
- GE Healthcare, Brøndby, Denmark
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California, Berkeley, CA, USA
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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40
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Bertelsen LB, Hansen ESS, Sadowski T, Ruf S, Laustsen C. Hyperpolarized pyruvate to measure the influence of PKM2 activation on glucose metabolism in the healthy kidney. NMR Biomed 2021; 34:e4583. [PMID: 34240478 DOI: 10.1002/nbm.4583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 06/13/2023]
Abstract
The purpose of the current study was to investigate if hyperpolarized [1-13 C]pyruvate can inform us on the metabolic consequences for the kidney glucose metabolism upon treatment with the pyruvate kinase M2 (PKM2) activator TEPP-46, which has shown promise as a novel therapeutic target for diabetic nephropathy. A healthy male Wistar rat model was employed to study the conversion of [1-13 C]pyruvate to [1-13 C]lactate in the kidney 2 and 4 h after treatment with TEPP-46. All rats were scanned with hyperpolarized [1-13 C]pyruvate kidney MR and vital parameters and blood samples were taken after scanning. The PKM2 activator TEPP-46 increases the glycolytic activity in the kidneys, leading to an increased lactate production, as seen by hyperpolarized pyruvate-to-lactate conversion. The results are supported by an increase in blood lactate, a decreased blood glucose level and an increased pyruvate kinase (PK) activity. The metabolic changes observed in both kidneys following treatment with TEPP-46 are largely independent of renal function and could as such represent a new and extremely sensitive metabolic readout for future drugs targeting PKM2. These results warrant further studies in disease models to evaluate if [1-13 C]pyruvate-to-[1-13 C]lactate conversion can predict treatment outcome.
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Affiliation(s)
- Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | | | - Sven Ruf
- Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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41
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Bengtsen MB, Hansen ESS, Tougaard RS, Lyhne MD, Rittig NF, Støy J, Jessen N, Mariager CØ, Stødkilde-Jørgensen H, Møller N, Laustsen C. Hyperpolarized [1- 13 C]pyruvate combined with the hyperinsulinaemic euglycaemic and hypoglycaemic clamp technique in skeletal muscle in a large animal model. Exp Physiol 2021; 106:2412-2422. [PMID: 34705304 PMCID: PMC9298727 DOI: 10.1113/ep089782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/20/2021] [Indexed: 11/08/2022]
Abstract
New Findings What is the central question of this study? Is it possible to combine the hyperpolarized magnetic resonance technique and the hyperinsulinaemic clamp method in order to evaluate skeletal muscle metabolism in a large animal model? What is the main finding and its importance? The logistical set‐up is possible, and we found substantial increments in glucose infusion rates representing skeletal muscle glucose uptake but no differences in ratios of [1‐13C]lactate to [1‐13C]pyruvate, [1‐13C]alanine to [1‐13C]pyruvate, and 13C‐bicarbonate to [1‐13C]pyruvate, implying that the hyperpolarization technique might not be optimal for detecting effects of insulin in skeletal muscle of anaesthetized animals, which is of significance for future studies.
Abstract In skeletal muscle, glucose metabolism is tightly regulated by the reciprocal relationship between insulin and adrenaline, with pyruvate being at the intersection of both pathways. Hyperpolarized magnetic resonance (hMR) is a new approach to gain insights into these pathways, and human trials involving hMR and skeletal muscle metabolism are imminent. We aimed to combine the hyperinsulinaemic clamp technique and hMR in a large animal model resembling human physiology. Fifteen anaesthetized pigs were randomized to saline (control group), hyperinsulinaemic euglycaemic clamp technique (HE group) or hyperinsulinaemic hypoglycaemic clamp technique (HH group). Skeletal muscle metabolism was evaluated by hyperpolarized [1‐13C]pyruvate injection and hMR at baseline and after intervention. The glucose infusion rate per kilogram increased by a statistically significant amount in the HE and HH groups (P < 0.001). Hyperpolarized magnetic resonance showed no statistically significant changes in metabolite ratios: [1‐13C]lactate to [1‐13C]pyruvate in the HH group versus control group (P = 0.19); and 13C‐bicarbonate to [1‐13C]pyruvate ratio in the HE group versus the control group (P = 0.12). We found evidence of profound increments in glucose infusion rates representing skeletal muscle glucose uptake, but interestingly, no signs of significant changes in aerobic and anaerobic metabolism using hMR. These results imply that hyperpolarized [1‐13C]pyruvate might not be optimally suited to detect effects of insulin in anaesthetized resting skeletal muscle, which is of significance for future studies.
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Affiliation(s)
- Mads Bisgaard Bengtsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | | | | | - Mads Dam Lyhne
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Nikolaj Fibiger Rittig
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark.,Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, Denmark
| | - Julie Støy
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, Denmark
| | - Niels Jessen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, Denmark
| | | | | | - Niels Møller
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Denmark
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Joergensen SH, Hansen ESS, Staehr PB, Laustsen C, Wiggers H. Human hyperpolarized [1-13C] pyruvate CMR and adenosine stress test. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Hyperpolarized (HP) [1-13C]pyruvate cardiac magnetic resonance (CMR) imaging can visualize myocardial perfusion and metabolism beyound glucose uptake. Depending on the prevailing metabolic conditions, buid-up of either [1-13C]lactate or 13C-bicarbonate can be measured. The aim of the present study was to assess cardiac metabolism using HP [1-13C]pyruvate rest-stress CMR.
Methods
Six healthy volunteers underwent cine CMR and HP [1-13C]pyruvate CMR at rest and during an adenosine stress test. Signal from HP [1-13C]pyruvate and its downstream metabolites was measured at the mid-left-ventricle (LV) level. We did semi-quantitative assessment of first-pass myocardial [1-13C]pyruvate perfusion. Pressure-volume loops were assessed non-invasively.
Results
Myocardial [1-13C]pyruvate perfusion was significantly increased during stress with a reduction in time-to-peak from 6.2±2.8 sec to 2.7±1.3 sec, p=0.04. This higher perfusion was accompanied by an overall increased myocardial uptake and metabolism. The conversion rate constant (kPL) for lactate increased from 0.011±0.009 sec–1 to 0.020±0.010 sec–1, p=0.04. The pyruvate oxidation (kPB) increased from 0.004±0.004 sec–1 to 0.012±0.007 sec–1, p=0.008. This increase in oxidative metabolism was positively correlated with heart rate (R2=0.44, p=0.02).
Conclusion
We observed a significant increase in carbohydrate oxidation during cardiac stress in the healthy human heart. The present study forms the basis for comparisons in future research in patients with heart failure and coronary artery disease. HP [1-13C]pyruvate CMR could be a possible alternative to PET in the future.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Danish Heart FoundationIndependent Research Fund, Denmark Increased conversion rate of pyruvateIncreased metabolite signal in LV
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Affiliation(s)
| | - E S S Hansen
- Aarhus University, The MR Research Centre, Aarhus, Denmark
| | - P B Staehr
- North Denmark Regional Hospital, Hjoerring, Denmark
| | - C Laustsen
- Aarhus University, The MR Research Centre, Aarhus, Denmark
| | - H Wiggers
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
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Bech SK, Qi H, Mariager CØ, Hansen ESS, Ilicak E, Zöllner FG, Laustsen C. The number of glomeruli and pyruvate metabolism is not strongly coupled in the healthy rat kidney. Magn Reson Med 2021; 87:896-903. [PMID: 34554602 DOI: 10.1002/mrm.29025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/23/2021] [Accepted: 09/07/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE The number of glomeruli is different in men and women, as they also present different prevalence and progression of chronic kidney disease. A recent study has demonstrated a potential difference in renal metabolism between sexes, and a potential explanation could be the differences in glomeruli number. This study investigates the potential correlation between glomerular number and pyruvate metabolism in healthy kidneys. METHODS This study is an experimental study with rats (N = 12). We used cationized-ferritin MRI to visualize and count glomeruli and hyperpolarized [1-13 C]pyruvate to map the metabolism. Dynamic contrast-enhanced MRI was used to analyze kidney hemodynamics using gadolinium tracer. RESULTS Data showed no or subtle correlation between the number of glomeruli and the pyruvate metabolism. Minor differences were observed in the number of glomeruli (female = 24,509 vs. male = 26 350; p = .16), renal plasma flow (female = 606.6 vs. male= 455.7 ml/min/100 g; p = .18), and volume of distribution (female = 87.44 vs. male = 76.61 ml/100 ml; p = .54) between sexes. Mean transit time was significantly prolonged in males compared with females (female = 8.868 s vs. male = 10.63 s; p = .04). CONCLUSION No strong statistically significant correlation between the number of glomeruli and the pyruvate metabolism was found in healthy rat kidneys.
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Affiliation(s)
- Sabrina Kahina Bech
- MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Haiyun Qi
- MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | | | - Efe Ilicak
- Computer Assisted Clinical Medicine, Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frank G Zöllner
- Computer Assisted Clinical Medicine, Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Cooperative Core Facility Animal Scanner ZI, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christoffer Laustsen
- MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Tougaard RS, Laustsen C, Lassen TR, Qi H, Lindhardt JL, Schroeder M, Jespersen NR, Hansen ESS, Ringgaard S, Bøtker HE, Kim WY, Stødkilde-Jørgensen H, Wiggers H. Remodeling after myocardial infarction and effects of heart failure treatment investigated by hyperpolarized [1- 13 C]pyruvate magnetic resonance spectroscopy. Magn Reson Med 2021; 87:57-69. [PMID: 34378800 DOI: 10.1002/mrm.28964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE Hyperpolarized [1-13 C]pyruvate MRS can measure cardiac metabolism in vivo. We investigated whether [1-13 C]pyruvate MRS could predict left ventricular remodeling following myocardial infarction (MI), long-term left ventricular effects of heart failure medication, and could identify responders to treatment. METHODS Thirty-five rats were scanned with hyperpolarized [1-13 C]pyruvate MRS 3 days after MI or sham surgery. The animals were re-examined after 30 days of therapy with β-blockers and ACE-inhibitors (active group, n = 12), placebo treatment (placebo group, n = 13) or no treatment (sham group, n = 10). Furthermore, heart tissue mitochondrial respiratory capacity was assessed by high-resolution respirometry. Metabolic results were compared between groups, over time and correlated to functional MR data at each time point. RESULTS At 30 ± 0.5 days post MI, left ventricular ejection fraction (LVEF) differed between groups (sham, 77% ± 1%; placebo, 52% ± 3%; active, 63% ± 2%, P < .001). Cardiac metabolism, measured by both hyperpolarized [1-13 C]pyruvate MRS and respirometry, neither differed between groups nor between baseline and follow-up. Three days post MI, low bicarbonate + CO2 /pyruvate ratio was associated with low LVEF. At follow-up, in the active group, a poor recovery of LVEF was associated with high bicarbonate + CO2 /pyruvate ratio, as measured by hyperpolarized MRS. CONCLUSION In a rat model of moderate heart failure, medical treatment improved function, but did not on average influence [1-13 C]pyruvate flux as measured by MRS; however, responders to heart failure medication had reduced capacity for carbohydrate metabolism.
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Affiliation(s)
- Rasmus Stilling Tougaard
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.,MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | | | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Jakob Lykke Lindhardt
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Marie Schroeder
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | | | | | - Steffen Ringgaard
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Won Yong Kim
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.,MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | | | - Henrik Wiggers
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
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Agger P, Hyldebrandt JA, Hansen ESS, Omann C, Bøgh N, Waziri F, Nielsen PM, Laustsen C. Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure. Eur Heart J Cardiovasc Imaging 2021; 21:93-101. [PMID: 31329841 PMCID: PMC6923679 DOI: 10.1093/ehjci/jez074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/24/2019] [Accepted: 04/02/2019] [Indexed: 12/31/2022] Open
Abstract
Aims Early detection of heart failure is important for timely treatment. During the development of heart failure, adaptive intracellular metabolic processes that evolve prior to macro-anatomic remodelling, could provide an early signal of impending failure. We hypothesized that metabolic imaging with hyperpolarized magnetic resonance would detect the early development of heart failure before conventional echocardiography could reveal cardiac dysfunction. Methods and results Five 8.5 kg piglets were subjected to pulmonary banding and subsequently examined by [1-13C]pyruvate hyperpolarization, conventional magnetic resonance imaging, echocardiography, and blood testing, every 4 weeks for 16 weeks. They were compared with a weight matched, healthy control group. Conductance catheter examination at the end of the study showed impaired right ventricular systolic function along with compromised left ventricular diastolic function. After 16 weeks, we saw a significant decrease in the conversion ratio of pyruvate/bicarbonate in the left ventricle from 0.13 (0.04) in controls to 0.07 (0.02) in animals with pulmonary banding, along with a significant increase in the lactate/bicarbonate ratio to 3.47 (1.57) compared with 1.34 (0.81) in controls. N-terminal pro-hormone of brain natriuretic peptide was increased by more than 300%, while cardiac index was reduced to 2.8 (0.95) L/min/m2 compared with 3.9 (0.95) in controls. Echocardiography revealed no changes. Conclusion Hyperpolarization detected a shift towards anaerobic metabolism in early stages of right ventricular dysfunction, as evident by an increased lactate/bicarbonate ratio. Dysfunction was confirmed with conductance catheter assessment, but could not be detected by echocardiography. Hyperpolarization has a promising future in clinical assessment of heart failure in both acquired and congenital heart disease.
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Affiliation(s)
- Peter Agger
- Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
| | - Janus Adler Hyldebrandt
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark.,Department of Anaesthesiology and Intensive Care, Akershus University Hospital, Sykehusveien 25, Lørenskog, Norway
| | | | - Camilla Omann
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
| | - Nikolaj Bøgh
- MR Research Centre, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Farhad Waziri
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark
| | - Per Mose Nielsen
- MR Research Centre, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Christoffer Laustsen
- MR Research Centre, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
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Laustsen C. Renal MR Fingerprinting: A Novel Solution to a Complex Problem. Radiology 2021; 300:388-389. [PMID: 34100689 DOI: 10.1148/radiol.2021210924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Christoffer Laustsen
- From the MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd, 8200 Aarhus, Denmark
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Wen Y, Qi H, Østergaard Mariager C, Mose Nielsen P, Bonde Bertelsen L, Stødkilde-Jørgensen H, Laustsen C. Sex Differences in Kidney Function and Metabolism Assessed Using Hyperpolarized [1- 13C]Pyruvate Interleaved Spectroscopy and Nonspecific Imaging. ACTA ACUST UNITED AC 2021; 6:5-13. [PMID: 32280745 PMCID: PMC7138520 DOI: 10.18383/j.tom.2020.00022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Metabolic sex differences have recently been shown to be particularly important in tailoring treatment strategies. Sex has a major effect on fat turnover rates and plasma lipid delivery in the body. Differences in kidney structure and transporters between male and female animals have been found. Here we investigated sex-specific renal pyruvate metabolic flux and whole-kidney functional status in age-matched healthy Wistar rats. Blood oxygenation level–dependent and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) were used to assess functional status. Hyperpolarized [1-13C]pyruvate was used to assess the metabolic differences between male and female rats. Female rats had a 41% ± 3% and 41% ± 5% lower absolute body and kidney weight, respectively, than age-matched male rats. No difference was seen between age-matched male and female rats in the kidney-to-body weight ratio. A 56% ± 11% lower lactate production per mL/100 mL/min was found in female rats than in age-matched male rats measured by hyperpolarized magnetic resonance and DCE MRI. Female rats had a 33% ± 11% higher glomerular filtration rate than age-matched male rats measured by DCE MRI. A similar renal oxygen tension (T2*) was found between age-matched male and female rats as shown by blood oxygenation level–dependent MRI. The results were largely independent of the pyruvate volume and the difference in body weight. This study shows an existing metabolic difference between kidneys in age-matched male and female rats, which indicates that sex differences need to be considered when performing animal experiments.
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Affiliation(s)
- Yibo Wen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; and.,The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Henan, China
| | - Haiyun Qi
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; and
| | | | - Per Mose Nielsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; and
| | - Lotte Bonde Bertelsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; and
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; and
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Vaeggemose M, F. Schulte R, Laustsen C. Comprehensive Literature Review of Hyperpolarized Carbon-13 MRI: The Road to Clinical Application. Metabolites 2021; 11:metabo11040219. [PMID: 33916803 PMCID: PMC8067176 DOI: 10.3390/metabo11040219] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 01/02/2023] Open
Abstract
This review provides a comprehensive assessment of the development of hyperpolarized (HP) carbon-13 metabolic MRI from the early days to the present with a focus on clinical applications. The status and upcoming challenges of translating HP carbon-13 into clinical application are reviewed, along with the complexity, technical advancements, and future directions. The road to clinical application is discussed regarding clinical needs and technological advancements, highlighting the most recent successes of metabolic imaging with hyperpolarized carbon-13 MRI. Given the current state of hyperpolarized carbon-13 MRI, the conclusion of this review is that the workflow for hyperpolarized carbon-13 MRI is the limiting factor.
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Affiliation(s)
- Michael Vaeggemose
- GE Healthcare, 2605 Brondby, Denmark;
- MR Research Centre, Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
- Correspondence:
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Dwork N, Gordon JW, Tang S, O'Connor D, Hansen ESS, Laustsen C, Larson PEZ. Di-chromatic interpolation of magnetic resonance metabolic images. MAGMA 2021; 34:57-72. [PMID: 33502669 DOI: 10.1007/s10334-020-00903-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Magnetic resonance imaging with hyperpolarized contrast agents can provide unprecedented in vivo measurements of metabolism, but yields images that are lower resolution than that achieved with proton anatomical imaging. In order to spatially localize the metabolic activity, the metabolic image must be interpolated to the size of the proton image. The most common methods for choosing the unknown values rely exclusively on values of the original uninterpolated image. METHODS In this work, we present an alternative method that uses the higher-resolution proton image to provide additional spatial structure. The interpolated image is the result of a convex optimization algorithm which is solved with the fast iterative shrinkage threshold algorithm (FISTA). RESULTS Results are shown with images of hyperpolarized pyruvate, lactate, and bicarbonate using data of the heart and brain from healthy human volunteers, a healthy porcine heart, and a human with prostate cancer.
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Affiliation(s)
- Nicholas Dwork
- Department of Radiology and Biomedical Imaging, University of California in San Francisco, San Francisco, USA.
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California in San Francisco, San Francisco, USA
| | - Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of California in San Francisco, San Francisco, USA
| | - Daniel O'Connor
- Department of Mathematics and Statistics, University of San Francisco, San Francisco, USA
| | | | | | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California in San Francisco, San Francisco, USA
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Affiliation(s)
| | - Christoffer Laustsen
- Department of Clinical Medicine, The MR Research Centre, Aarhus University, Aarhus, Denmark
| | - Jaap A Joles
- Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Patrick B Mark
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Steven Sourbron
- Department of Imaging, Infection, Immunity and Cardiovascular Disease, University of Sheffield, 18 Claremont Crescent, Sheffield, S10 2TA, UK.
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