Overestimation of cardiac lactate production caused by liver metabolism of hyperpolarized [1- 13 C]pyruvate.

PURPOSE: The purpose of this work was to study the contribution of liver [1-13 C]lactate to the lactate signal detected in the heart following injection of hyperpolarized [1-13 C]pyruvate.

METHODS: A slice-selective saturation scheme was incorporated into a hybrid metabolic imaging and spectroscopy approach to selectively presaturate lactate in the liver. Imaging and slice-selective spectroscopy of [1-13 C]pyruvate and its downstream metabolites were sequentially interleaved in the same experiment with optional presaturation of liver [1-13 C]lactate. Six healthy rats were measured, and metabolic data in the heart acquired with and without presaturation of liver lactate were compared.

RESULTS: When using liver lactate presaturation, a statistically significant reduction of the lactate/pyruvate ratio was observed in the spectroscopic data of the left ventricle (0.18 ± 0.03 versus 0.24 ± 0.04; p < .05) as well as in the imaging data of the blood pool (0.05 ± 0.01 versus 0.11 ± 0.01; p < .05). No significant difference in myocardial lactate was observed when using myocardium only as the region of interest in the imaging data (0.08 ± 0.01 versus 0.11 ± 0.02; p = .2).

CONCLUSION: Liver metabolism leads to statistically significant overestimation of cardiac lactate production in slice-selective or nonselective spectroscopic experiments. Therefore, metabolic imaging is preferred over spectroscopy to separate left-ventricular compartments within the slice and hence avoid contamination of cardiac lactate signals. Alternatively, presaturation pulses should be used in combination with spectroscopy approaches.