
==== Front
ArXiv
ArXiv
arxiv
ArXiv
2331-8422
Cornell University

arXiv:2409.06664v1
2409.06664
1
preprint
Article
Initial Experience of Metabolic Imaging with Hyperpolarized [1-13C]pyruvate MRI in Kidney Transplant Patients
Liu Xiaoxi
Lai. Ying-Chieh
Cui Di
Kung Shiang-Cheng
Park Meyeon
Zoltan Laszik
Larson Peder E. Z.
Wang Zhen J.
10 9 2024
arXiv:2409.06664v1https://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License, which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.
http://arxiv.org/abs/2409.06664v1
nihpp-2409.06664v1.pdf
BACKGROUND: Kidney transplant is the treatment of choice for patients with end-stage renal disease. Early detection of allograft injury is important to delay or prevent irreversible damage. PURPOSE: To investigate the feasibility of hyperpolarized (HP) [1-13C]pyruvate MRI for assessing kidney allograft metabolism. SUBJECTS: 6 participants (mean age, 45.2 +- 12.4 years, 2 females) scheduled for kidney allograft biopsy and 5 patients (mean age, 59.6 +- 10.4 years, 2 females) with renal cell carcinoma (RCC). ASSESSMENT: Five of the six kidney allograft participants underwent biopsy after MRI. Estimated glomerular filtration rate (eGFR) and urine protein-to-creatine ratio (uPCR) were collected within 4 weeks of MRI. Kidney metabolism was quantified from HP [1-13C]pyruvate MRI using the lactate-to-pyruvate ratio in allograft kidneys and non-tumor bearing kidneys from RCC patients. RESULTS: Biopsy was performed a mean of 9 days (range 5-19 days) after HP [1-13C]pyruvate MRI. Three biopsies were normal, one showed low-grade fibrosis and one showed moderate microvascular inflammation. All had stable functioning allografts with eGFR > 60 mL/min/1.73 m2 and normal uPCR. One participant who did not undergo biopsy had reduced eGFR of 49 mL/min/1.73 m2 and elevated uPCR. The mean lactate-to-pyruvate ratio was 0.373 in participants with normal findings (n = 3) and 0.552 in participants with abnormal findings (n = 2). The lactate-to-pyruvate ratio was highest (0.847) in the participant with reduced eGFR and elevated uPRC. Native non-tumor bearing kidneys had a mean lactate-to-pyruvate ratio of 0.309. DATA CONCLUSION: Stable allografts with normal findings at biopsy showed lactate-to-pyruvate ratios similar to native non-tumor bearing kidneys, whereas allografts with abnormal findings showed higher lactate-to-pyruvate ratios.

J Magn Reson Imaging (2024)
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pmc
