Ex Vivo Human Placenta Perfusion, Metabolic and Functional Imaging for Obstetric Research—A Feasibility Study

Abstract

Placenta metabolism is closely linked to pregnancy outcome, and few modalities are currently available for studying the human placenta. Here, we aimed to investigate a novel ex vivo human placenta perfusion system for metabolic imaging using hyperpolarized [1-13C]pyruvate. The metabolic effects of 3 different human placentas were investigated using functional and metabolic magnetic resonance imaging. The placenta glucose metabolism and hemodynamics were characterized with hyperpolarized [1-13C]pyruvate magnetic resonance imaging and by dynamic contrast-enhanced (DCE) imaging. Hyperpolarized [1-13C]pyruvate showed a decrease in the 13C-lactate/13C-pyruvate ratio from the highest to the lowest metabolic active placenta. The metabolic profile was complemented by a more homogenous distributed hemodynamic response, with a longer mean transit time and higher blood volume. This study shows different placenta metabolic and hemodynamic features associated with the placenta functional status using hyperpolarized magnetic resonance ex vivo. This study supports further studies using ex vivo metabolic imaging of the placenta alterations associated with pregnancy complications.

Placental MRI: Development of an MRI compatible ex vivo system for whole placenta dual perfusion

“…There have also been efforts to bridge hemodynamics and metabolism through UA perfusion of hyperpolarized 13 C-pyruvate while performing MR spectroscopy and CE MRI [18].…”

Comprehensive Literature Review of Hyperpolarized Carbon-13 MRI: The Road to Clinical Application

“…This review focuses on the clinical transition; therefore, areas other than those listed in the previous sections (e.g., lung [ 132 , 133 ], angiography [ 134 ], placenta [ 135 , 136 ], muscle [ 137 , 138 , 139 ]), diseases (e.g., diabetes [ 63 , 140 , 141 , 142 ], rheumatoid arthritis [ 143 , 144 ], toxin-induced neuroinflammation [ 145 ], radiation injury [ 146 , 147 ]), and physiology (e.g., cell metabolism [ 148 , 149 ], pH [ 130 ], blood serum [ 150 , 151 ], bacteria metabolism [ 152 ]) are not be covered.…”

The Role of the 3Rs for Understanding and Modeling the Human Placenta

“…Perfusion systems tend to be used for a short time period, around four to six hours, and can be maintained for a maximum of 24 h. The parameters of the perfusion systems are both controllable and measurable: blood flow on both the maternal and fetal side is controllable, pressure can be measured, the arterial O 2 concentration and arterial pH can be determined experimentally, metabolites can be measured at the venous outlet and diffusion across the placental barrier can de be determined [ 42 , 43 ]. A new advance in the ex vivo perfusion model has been recently reported, where [1- 13 C]pyruvate was used to characterize glucose metabolism by magnetic resonance imaging (MRI) and by dynamic contrast-enhanced (DCE) imaging in perfused placentas, highlighting its significant application in the study of placental metabolism and pregnancy complications [ 44 ].…”