Regional quantification of metabolic liver function using hyperpolarized [1-¹³C] pyruvate MRI

Area of Science:

• Medical Imaging
• Hepatology
• Metabolic Research

Background:

• Assessing liver function is crucial before partial hepatectomy to prevent liver failure.
• Current methods relying on future liver remnant (FLR) volume may not accurately reflect liver function.
• Liver metabolism, not just volume, is a key indicator of functional capacity.

Purpose of the Study:

• To investigate metabolic changes in the FLR and deportalized liver (DL) after partial portal vein ligation (PVL) in a porcine model.
• To quantify pyruvate metabolism in the FLR and DL using hyperpolarized magnetic resonance imaging (HP-MRI).
• To compare metabolic activity between the FLR and DL to better understand regional liver function.

Main Methods:

• Utilized a porcine model undergoing partial portal vein ligation (PVL).
• Employed hyperpolarized [1-¹³C] pyruvate magnetic resonance imaging (HP-MRI) at baseline, post-surgery, and 1 week after surgery.
• Quantified pyruvate-to-lactate (k_PL) and pyruvate-to-alanine (k_PA) conversion rates using kinetic modeling.

Main Results:

• A significant increase in pyruvate-to-lactate conversion (k_PL) was observed in the FLR compared to the DL post-surgery and at 1 week (P = 0.002).
• Pyruvate-to-alanine conversion (k_PA) remained unchanged between the FLR and DL (P = 0.761).
• Findings suggest a metabolic shift towards glycolysis in the liver remnant.

Conclusions:

• HP-MRI provides a non-invasive method to evaluate regional liver function.
• Metabolic assessment using HP-MRI can complement traditional volume-based assessments before partial hepatectomy.
• This approach holds potential for improving patient outcomes by enabling more accurate risk stratification for post-hepatectomy liver failure.