Simulcast X-nuclei Magnetic Resonance Imaging for Pathological Dynamics of Immune-Related Hepatitis in Rabbit

Motivation: Immune-related hepatitis (IRH) is a serious side effect of tumor immunotherapy, often causing severe liver damage without early diagnostic markers. Conventional MRI is inadequate for early-stage detection. Goal(s): To develop a simulcast X-nuclei MRI technique for early detection of IRH by monitoring microenvironmental changes such as hepatocyte edema, macrophage polarization, and metabolic shifts. Approach: IRH was induced in rabbits, and simultaneous 1H/19F/23Na/31P MRI was conducted hourly to capture structural and metabolic changes. Blood and histological analysis validated imaging findings. Results: 23Na MRI revealed hepatocyte edema, 31P MRSI indicated metabolic stress, dynamic 19F changes tracked macrophage activity, enabling real-time assessment of inflammation and injury. Impact: This work highlights the potential of simulcast X-nuclei MRI in early detection and management of immune-related hepatitis.