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Abstract #2945

Increased Cerebral Lactate-to-Pyruvate Ratio in Primary Progressive Multiple Sclerosis using Hyperpolarized Pyruvate MRI.

Jordan J. McGing1, Marco Pisa2, Andrew Lockhart2, Kylie Yeung 1,3,4, Aaron Axford1, Rebecca Mills1, Ayaka Shinozaki1,5, Andrew Lewis1, Sarah Birkhoelzer1, Lise Berner3, Fulvio Zaccagna6, Rolf Schulte7, Oliver Rider1, Gabrielle De Luca2, Damian J. Tyler1,5, and James T. Grist1,3
1Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom, 2Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom, 3Department of Radiology, Oxford University Hospitals, Oxford, United Kingdom, 4Department of Oncology, Oxford University Hospitals, Oxford, United Kingdom, 5Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom, 6Department of Radiology, Cambridge University Hospitals, Cambridge, United Kingdom, 7GE Healthcare, Munich, Germany

Synopsis

Keywords: Multiple Sclerosis, Multiple Sclerosis, Hyperpolarized MR (Non-Gas)

Motivation: There remains an absence of imaging modalities capable of probing the neuroinflammatory processes that precede the well-defined brain structural changes in Primary Progressive Multiple Sclerosis (PPMS).

Goal(s): We investigated whether hyperpolarized [1-13C]pyruvate MRI can delineate alterations in cerebral glycolytic and oxidative metabolism between treatment naïve PPMS and healthy volunteers.

Approach: Two treatment naïve PPMS patients and two sex matched healthy volunteers underwent [1-13C]pyruvate MRI to characterise cerebral glycolytic and oxidative metabolism.

Results: A global increase in [1-13C]lactate: [1-13C]pyruvate was found in both PPMS patients relative to sex-matched healthy controls (0.23 ± 0.12 vs 0.16 ± 0.08). The 13C bicarbonate:[1-13C]pyruvate ratio was no different.

Impact: These preliminary findings demonstrate a global increase in cerebral glycolytic metabolism in treatment naïve PPMS relative to age and gender matched healthy controls. This may reflect diffuse neuroinflammatory processes and suggests [1-13C]pyruvate MRI could be used to monitor disease activity.

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Keywords