Abstract
The liver is a key node of whole-body nutrient and fuel metabolism and is also the principal site for detoxification of xenobiotic compounds. As such, hepatic metabolite concentrations and/or turnover rates inform on the status of both hepatic and systemic metabolic diseases as well as the disposition of medications. As a tool to better understand liver metabolism in these settings, in vivo magnetic resonance spectroscopy (MRS) offers a non-invasive means of monitoring hepatic metabolic activity in real time both by direct observation of concentrations and dynamics of specific metabolites as well as by observation of their enrichment by stable isotope tracers. This review summarizes the applications and advances in human liver metabolic studies by in vivo MRS over the past 35 years and discusses future directions and opportunities that will be opened by the development of ultra-high field MR systems and by hyperpolarized stable isotope tracers.
Highlights
The liver represents a key metabolic node in the body encompassing nutrient transformation and fuel homeostasis as well as detoxification of ethanol and xenobiotic compounds.Its relatively large size and body location, coupled with a dynamic metabolome that features high concentrations of a diversity of metabolites such as glycogen, glutamine, ATP, sugar phosphates, phosphocholine and phosphoethanolamine, has made it an attractive target for in vivo magnetic resonance spectroscopy (MRS) studies of hepatic metabolism since the early days of in vivo MRS development [1,2,3,4]
Given that many diseases cause substantial changes in hepatic intermediary metabolism coupled with the availability of higher-field MRS systems for both in vivo human and animal model studies, there is high and ongoing interest in applying this methodology to further our understanding of hepatic intermediary metabolism in physiological and pathophysiological settings
The purpose of this review is to highlight the versatility of multinuclear in vivo MRS both in direct observation of hepatic metabolites as well as hepatic metabolite enrichment from metabolic stable-isotope tracers
Summary
The liver represents a key metabolic node in the body encompassing nutrient transformation and fuel homeostasis as well as detoxification of ethanol and xenobiotic compounds. Its relatively large size and body location, coupled with a dynamic metabolome that features high concentrations of a diversity of metabolites such as glycogen, glutamine, ATP, sugar phosphates, phosphocholine and phosphoethanolamine, has made it an attractive target for in vivo magnetic resonance spectroscopy (MRS) studies of hepatic metabolism since the early days of in vivo MRS development [1,2,3,4]. Given that many diseases cause substantial changes in hepatic intermediary metabolism coupled with the availability of higher-field MRS systems for both in vivo human and animal model studies, there is high and ongoing interest in applying this methodology to further our understanding of hepatic intermediary metabolism in physiological and pathophysiological settings.
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