Imaging Acute Metabolic Changes in Patients with Mild Traumatic Brain Injury Using Hyperpolarized [1-13C]Pyruvate
Edward P. Hackett,
Marco C. Pinho,
Crystal E. Harrison,
Galen D. Reed,
Jeff Liticker,
Jaffar Raza,
Ronald G. Hall,
Craig R. Malloy,
Surendra Barshikar,
Christopher J. Madden,
Jae Mo Park
Affiliations
Edward P. Hackett
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Marco C. Pinho
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Crystal E. Harrison
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Galen D. Reed
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; GE Healthcare, Dallas, TX 75390, USA
Jeff Liticker
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Jaffar Raza
Department of Pharmacy Practice, The Texas Tech University Health Sciences Center, Dallas, TX 75216, USA
Ronald G. Hall
Department of Pharmacy Practice, The Texas Tech University Health Sciences Center, Dallas, TX 75216, USA
Craig R. Malloy
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Surendra Barshikar
Department of Physical Medicine & Rehabilitation, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Christopher J. Madden
Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Jae Mo Park
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Electrical and Computer Engineering, The University of Texas at Dallas, Richardson TX 75080, USA; Corresponding author
Summary: Traumatic brain injury (TBI) involves complex secondary injury processes following the primary injury. The secondary injury is often associated with rapid metabolic shifts and impaired brain function immediately after the initial tissue damage. Magnetic resonance spectroscopic imaging (MRSI) coupled with hyperpolarization of 13C-labeled substrates provides a unique opportunity to map the metabolic changes in the brain after traumatic injury in real-time without invasive procedures. In this report, we investigated two patients with acute mild TBI (Glasgow coma scale 15) but no anatomical brain injury or hemorrhage. Patients were imaged with hyperpolarized [1-13C]pyruvate MRSI 1 or 6 days after head trauma. Both patients showed significantly reduced bicarbonate (HCO3–) production, and one showed hyperintense lactate production at the injured sites. This study reports the feasibility of imaging altered metabolism using hyperpolarized pyruvate in patients with TBI, demonstrating the translatability and sensitivity of the technology to cerebral metabolic changes after mild TBI.
