MacKenzie, J. D., Yen, Y. F., Mayer, D., Tropp, J. S., Hurd, R. E., & Spielman, D. M. (2011). Detection of inflammatory arthritis by using hyperpolarized 13C-pyruvate with MR imaging and spectroscopy. Radiology, 259(2), 414-420.
The data presented herein suggest that the presence of inflammation may be detected at 13C-MR spectroscopy as the increased conversion of hyperpolarized 13C-pyruvate into 13C-lactate.
To examine the feasibility of using magnetic resonance (MR) spectroscopy with hyperpolarized carbon 13 (13C)–labeled pyruvate to detect inflammation.
Materials and Methods
The animal care and use committee approved all work with animals. Arthritis was induced in the right hind paw of six rats; the left hind paw served as an internal control. The lactate dehydrogenase–catalyzed conversion of pyruvate to lactate was measured in inflamed and control paws by using 13C MR spectroscopy. Clinical and histologic data were obtained to confirm the presence and severity of arthritis. Hyperpolarized 13C-pyruvate was intravenously injected into the rats before simultaneous imaging of both paws with 13C MR spectroscopy. The Wilcoxon signed rank test was used to test for differences in metabolites between the control and arthritic paws.
All animals showed findings of inflammation in the affected paws and no signs of arthritis in the control paws at both visible inspection (clinical index of 3 for arthritic paws and 0 for control paws) and histologic examination (histologic score of 3–5 for arthritic paws and 0 for control paws). Analysis of the spectroscopic profiles of 13C-pyruvate and converted 13C-lactate showed an increase in the amount of 13C-lactate in inflamed paws (median lactate-to-pyruvate ratio, 0.50; mean lactate-to-pyruvate ratio ± standard deviation, 0.52 ± 0.16) versus control paws (median lactate-to-pyruvate ratio, 0.27; mean lactate-to-pyruvate ratio, 0.32 ± 0.11) (P < .03). The ratio of 13C-lactate to total 13C was also significantly increased in inflamed paws compared with control paws (P < .03).
These results suggest that alterations in the conversion of pyruvate to lactate as detected with 13C-MR spectroscopy may be indicative of the presence of inflammatory arthritis.