Magnetization transfer MRI of intragastric milk digestion: A feasibility study in humans

Gastric milk protein coagulation has been extensively studied using in vitro and animal models. Yet, verifying these results in humans remains essential. In this study, we assessed the feasibility of using MT MRI for monitoring milk protein coagulation in vivo in humans. Twelve adults underwent MRI scans before and after ingesting 300 g of milk with low- or high-protein denaturation (LPD or HPD, respectively). We assessed coagulation and gastric emptying dynamics by deriving the MT ratio (MTR), total gastric content (TGC), semi-solid, and liquid volumes. The MTR values increased during digestion for both milk products, indicating an increase in the degree of coagulation. Prolonged heating of milk did not affect the MTR (MD = 16 %, 95 % CI [10-21], p = 0.15), but resulted in higher TGC volumes (MD 40.3 mL, 95 % CI [25.5-55.1], p = 0.044), indicating slower gastric emptying. We thus showed that by combining MT with conventional anatomical MRI both milk protein coagulation and gastric emptying dynamics, and thereby the impact of heating on gastric milk digestion, can be assessed in vivo in humans. Our work underpins the feasibility of using MRI as a non-invasive imaging tool for studying the effects of food processing and composition on gastric digestion.