Non-Invasive Assessment of Hepatic Ischemia-Reperfusion Injury Using Dynamic Contrast Enhanced-MRI and T2 Mapping
1Lombardi Comprehensive Cancer Center and the Center for Translational Imaging, Georgetown University Medical Center, Washington, DC, 2MedStar Georgetown Transplant Institute, Washington, DC, 3Pathology, MedStar Georgetown University Hospital, Washington, DC
Meeting: 2022 American Transplant Congress
Abstract number: 658
Keywords: Inflammation, Liver, Mice, Warm ischemia
Topic: Basic Science » Basic Science » 14 - Ischemia Reperfusion
Session Information
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: Hepatic ischemia-reperfusion injury (IRI) is a consequence of liver transplantation and hepatectomy that varies in severity and clinical significance. The diagnosis is made based on laboratory evaluation and invasive liver biopsy. Magnetic resonance imaging (MRI) is a valuable diagnostic imaging modality for the assessment of liver structure/function. In this study, we evaluate dynamic contrast-enhanced MRI (DCE-MRI) and T2 mapping as non-invasive means to diagnose and grade hepatic IRI severity.
*Methods: Adult C57BL/6 mice underwent baseline MRI with gadoxetate disodium-DCE-MRI using a T1-weighted RARE protocol and T2 mapping using an MSME sequence. Importantly, DCE-MRI was performed continuously for a totality of 30 minutes. Mice were subjected to sham operations versus partial hepatic ischemia in the left and median lobes for 45 minutes, which simulated the average warm ischemia time during transplantation. Reperfusion occurred for 24 hours post-procedure with subsequent re-imaging.
*Results: The kinetics of contrast uptake by the liver were drastically altered as a consequence of IRI. This was consistent with a significant (p<0.0001) rise in serum alanine aminotransferase. Interestingly, prolonged DCE-MRI, a surrogate of perfusion and function, revealed rapid uptake and excretion of contrast while never reaching comparable maximum mean intensities. This was apparent throughout the entire liver and there were no associated biochemical changes in total or direct bilirubin levels. Comparatively, there were also significant differences in the differential T2 mapping values observed following IRI, which translates to increased edema and inflammation. This change was largely isolated to the left and median lobes of the liver and was consistent with the influx of neutrophils and macrophages as apparent by Gr-1 and CD-68 immunohistochemical staining, despite no significant pathological differences using the Suzuki scoring system.
*Conclusions: T2 mapping and dynamic DCE-MRI can detect hepatic IRI in a clinically significant and comparable manner. This provides context for future studies to optimize non-invasive diagnostic tools for hepatic IRI.
To cite this abstract in AMA style:
Rodriguez OC, Liggett JR, Kang J, Loh K, Lee Y, Sang N, He B, Cui Y, Oza K, Kwon D, Kallakury B, Fishbein T, Cui W, Khan K, Albanese C, Kroemer A. Non-Invasive Assessment of Hepatic Ischemia-Reperfusion Injury Using Dynamic Contrast Enhanced-MRI and T2 Mapping [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/non-invasive-assessment-of-hepatic-ischemia-reperfusion-injury-using-dynamic-contrast-enhanced-mri-and-t2-mapping/. Accessed November 21, 2024.« Back to 2022 American Transplant Congress