TY - JOUR
T1 - Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRI
AU - Kjaergaard, Uffe
AU - Lund, Andrea
AU - Redda, Mohsen
AU - Kristensen, Mattias Hedegaard
AU - Aastrup, Malene
AU - Bøgh, Nikolaj
AU - Sivesgaard, Kim
AU - Ohliger, Michael A.
AU - Vigneron, Daniel B.
AU - Bertelsen, Lotte Bonde
AU - Alstrup, Aage Kristian Olsen
AU - Hansen, Esben Søvsø Szocska
AU - Mortensen, Frank Viborg
AU - Laustsen, Christoffer
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/12
Y1 - 2025/12
N2 - Assessment of liver function is essential before partial hepatectomy to predict the risk of post hepatectomy liver failure, a severe and life-threatening complication. Traditional methods have focused on expected future liver remnant (FLR) volume estimation. However, liver volume does not always correlate with function. We suggest that metabolism might be a better surrogate for function than volume. Therefore, we aimed to investigate the metabolic changes in a porcine model of partial portal vein ligation (PVL) using hyperpolarized magnetic resonance imaging (HP-MRI). Specifically, we sought to quantify and compare the pyruvate metabolism in the FLR and the deportalized liver (DL). Six pigs underwent PVL. HP-MRI with [1-13C] pyruvate was performed at baseline, post-surgery, and 1 week after surgery. Metabolic conversion was quantified with kinetic modelling of the rate constants of pyruvate to lactate (kPL) and pyruvate to alanine (kPA). Mean kPL was increased in FLR compared to DL at post-surgery and 1 week after surgery (P = 0.002), while kPA was unaltered (P = 0.761). These findings indicate a metabolic shift towards glycolysis in the FLR. This non-invasive metabolic imaging technique could serve as a powerful tool for evaluation of regional liver function prior to partial hepatectomy and consequently improve patient outcomes.
AB - Assessment of liver function is essential before partial hepatectomy to predict the risk of post hepatectomy liver failure, a severe and life-threatening complication. Traditional methods have focused on expected future liver remnant (FLR) volume estimation. However, liver volume does not always correlate with function. We suggest that metabolism might be a better surrogate for function than volume. Therefore, we aimed to investigate the metabolic changes in a porcine model of partial portal vein ligation (PVL) using hyperpolarized magnetic resonance imaging (HP-MRI). Specifically, we sought to quantify and compare the pyruvate metabolism in the FLR and the deportalized liver (DL). Six pigs underwent PVL. HP-MRI with [1-13C] pyruvate was performed at baseline, post-surgery, and 1 week after surgery. Metabolic conversion was quantified with kinetic modelling of the rate constants of pyruvate to lactate (kPL) and pyruvate to alanine (kPA). Mean kPL was increased in FLR compared to DL at post-surgery and 1 week after surgery (P = 0.002), while kPA was unaltered (P = 0.761). These findings indicate a metabolic shift towards glycolysis in the FLR. This non-invasive metabolic imaging technique could serve as a powerful tool for evaluation of regional liver function prior to partial hepatectomy and consequently improve patient outcomes.
KW - Alanine aminotransferase (ALT)
KW - Gadoxetate-enhanced imaging
KW - Hepatic function
KW - Hyperpolarized
KW - Lactate dehydrogenase (LDH)
KW - Liver regeneration
KW - Magnetic resonance imaging
KW - Metabolic imaging
KW - Portal vein ligation
KW - Post-hepatectomy liver failure (PHLF)
KW - Translational
UR - http://www.scopus.com/inward/record.url?scp=105001314415&partnerID=8YFLogxK
U2 - 10.1038/s41598-025-93725-8
DO - 10.1038/s41598-025-93725-8
M3 - Journal article
C2 - 40140493
AN - SCOPUS:105001314415
SN - 2045-2322
VL - 15
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 10482
ER -