Journal article
Metabolic MRI with hyperpolarized [1-13C]pyruvate separates benign oligemia from infarcting penumbra in porcine stroke
Aarhus University1
Hyperpolarization & Metabolism, Magnetic Resonance, Department of Health Technology, Technical University of Denmark2
Magnetic Resonance, Department of Health Technology, Technical University of Denmark3
Department of Health Technology, Technical University of Denmark4
University of California at San Francisco5
Aarhus University Hospital6
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.
Language: | English |
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Publisher: | SAGE Publications |
Year: | 2021 |
Pages: | 2916-2927 |
ISSN: | 15597016 and 0271678x |
Types: | Journal article |
DOI: | 10.1177/0271678X211018317 |
ORCIDs: | Olin, Rie B. , Sánchez-Heredia, Juan D. , Ardenkjær-Larsen, Jan H. , 0000-0002-0321-3269 , 0000-0001-5512-9870 and 0000-0003-2760-4886 |