Maaike Konig1, Li Shen Ho1, Ayhan Gursan1, Woutjan Branderhorst1, Dennis Klomp1, Jeanine Prompers1,2
1Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands 2Departments of Human Biology and Imaging, NUTRIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
Background: The liver plays an important role in the impaired glucose homeostasis of type 2 diabetes patients. In current clinical practice, no radiation-free, non-invasive method exists to directly assess hepatic glucose metabolism. Deuterium metabolic imaging (DMI) is a novel, non-invasive 3D magnetic resonance spectroscopic imaging method that uses 2H-labeled substrates, such as deuterated glucose, to assess tissue metabolism in vivo. Therefore, DMI can play a pivotal role in gaining more insight into the impaired hepatic glucose metabolism of diabetes patients.
Methods: In three healthy subjects, dynamic DMI acquisitions (10 min per scan) were performed after oral [6,6’-2H2]glucose (20 g) administration to measure deuterated water and 2H-glucose signals in the liver over a time period of 120 min. Additionally, blood was sampled to measure total plasma glucose levels every 10 min.
Results: For all three subjects, the 2H-glucose signals in the liver, normalized to the signal of deuterated water at baseline, increased during the initial 50-60 min after [6,6’-2H2]glucose administration. Hereafter, the 2H-glucose signal in subjects 2 and 3 reached a maximum and slowly decreased. The 2H-glucose signal in subject 1 increased up to ~80 min and reached a ~50% higher maximum value compared to the other subjects. The kinetics of total plasma glucose concentrations closely followed that of the 2H-glucose signals in the liver, with the maximum plasma glucose level occurring ~30 min later in subject 1 compared to subjects 2 and 3.
Discussion/Conclusion: DMI can be used to quantify 2H-glucose signals in the liver and characterize individual hepatic glucose metabolism.