# Characterization of myocardial infarction by in vivo chemical exchange saturation transfer magnetic resonance imaging using natural D-glucose

## TL;DR

This study shows that natural D-glucose can be used as a biodegradable MRI contrast agent to detect heart attack regions in mice.

## Contribution

The novel use of natural D-glucose in glucoCEST MRI for myocardial infarction detection is demonstrated.

## Key findings

- GlucoCEST MRI effectively identified MI regions similar to conventional LGE imaging.
- Ex vivo mass spectrometry confirmed glucose and gadolinium accumulation in MI regions.
- Results were comparable to standard imaging techniques in differentiating MI from healthy tissue.

## Abstract

Cardiovascular magnetic resonance (CMR), the gold standard approach for characterizing myocardial infarction (MI), frequently relies on late gadolinium enhancement (LGE) using gadolinium-based contrast agents (GBCA). Whereas novel GBCAs targeting specific molecules have not yet entered clinical practice, chemical exchange saturation transfer (CEST) MRI shows promise for detecting various endogenous molecules. This study explored the potential of natural D-glucose as a biodegradable MRI contrast agent for imaging MI on day 7 by employing glucose-weighted CEST MRI (glucoCEST).

In vivo, the application of cardiac glucoCEST MTRasym (magnetization transfer ratio asymmetry) mapping delineated distinct pre- and postglucose infusion states in both healthy (n = 8) and MI-induced mice (n = 6) at 9.4T. This approach resulted in significant alterations in glucoCEST contrast, effectively identifying MI regions analogous to conventional LGE and immunohistochemical staining. Ex vivo mass spectrometry imaging confirmed elevated 13C-glucose and gadolinium accumulation in the MI region after exogenous administration, suggesting the potential of glucoCEST MRI for MI detection.

Our preclinical study on MI demonstrated that cardiac glucoCEST MRI utilizing natural D-glucose as a biodegradable contrast agent effectively differentiates between MI regions, remote myocardium (RM), and healthy myocardium. The results were comparable to those obtained using LGE imaging.

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