2-deoxy-D-glucose chemical exchange-sensitive spin-lock MRI of cerebral glucose metabolism after transient focal stroke in the rat

Rapid breakdown of cerebral glucose metabolism is a hallmark in stroke pathology. Metabolic activity delineates the penumbra from the infarct core, representing tissue that is potentially salvageable by therapeutic interventions. Tools to image dynamics of glucose and its spatial distribution could provide biomarkers of disease severity and of the success of therapeutic interventions. Here, we developed a new protocol to measure glucose transport and metabolism in a rat model of stroke using chemical exchange-sensitive spin-lock (CESL) MRI of the glucose analogue 2-deoxy-D-glucose (2DG). We further implemented a protocol that combines 2DG-CESL-MRI with perfusion and diffusion MRI to relate this new signal to established definitions of hypoperfused tissue, cytotoxic edema and the penumbra. We found that 2DG-CESL-MRI provides a biomarker of disturbed glucose transport and metabolism after stroke with high effect size. This is the first study to investigate CESL MRI of 2DG in the context of transport and metabolism imaging in rodent stroke.