In-vivo 7T 1H-MRS reveals different time courses of brain acetone and β-hydroxybutyrate after oral ketone monoester administration

Motivation: Exogeneous ketone body supplementation may achieve some of the health benefits of ketosis without imposing a restrictive diet and fasting. Goal(s): To investigate the pharmacokinetics of ketone bodies in the brain after ketone monoester (KME) supplementation using high-field 1H-MRS in healthy controls and patients with IDH-mutant glioma. Approach: Participants were measured using 7T 1H-MRS following KME ingestion to non-invasively detect and quantify ketones and cerebral metabolites over time. Results: Ketone signals, i.e., β-hydroxybutyrate and acetone, are clearly resolved in MR spectra. β-hydroxybutyrate level increased immediately after KME-ingestion, peaking around one hour, whereas acetone levels exhibited a more gradual rise. Impact: Ketone monoester supplementation is a complementary therapeutic strategy for many diseases, but data on ketone dynamics in the brain are limited. High-field MRS can be used to investigate pharmacokinetics of ketones in healthy tissue as well as in tumors.