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Non-Alcoholic Fatty Liver DiseaseNCT06176079

Hyperpolarized Pyruvate (13C) Magnetic Resonance Imaging In Patients With Fatty Liver Disease

An observational study of Non-Alcoholic Fatty Liver Disease and Non Alcoholic Fatty Liver, run by Michael Ohliger, MD PhD at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The recent development of dissolution dynamic nuclear polarization (DNP) technology for hyperpolarized (HP) 13C imaging offers a promising new avenue for non-invasively accessing fundamental metabolic changes associated with the progression of fatty liver disease in vivo. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Hyperpolarized (HP) 13C, Hyperpolarized 13C-Urea and Magnetic Resonance Imaging
How many people
44 participants
Where
1 siteUnited States
Study dates
22 Jul 2020to 28 Aug 2025
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Adult patients with diagnosed NASH or NAFLD, or adult healthy volunteers.

Who may be able to join

  • Part 1 (Imaging Optimization):
  • Able and willing to sign informed consent.
  • Age >= 18 years old at the time of study entry.
  • Part 2 (Pilot Study):
  • Group 1 (Fatty Liver Patients without NASH):
  • NAFL as determined by either clinical suspicion of fatty liver disease based on:
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  • steatosis by imaging or histology,
  • no significant alcohol consumption,
  • absence of coexisting liver disease OR NAFL determined by liver biopsy 3 months prior to the scan, with the presence of fat on histology but absent ballooning or fibrosis. (nonalcoholic steatohepatitis activity score (NAS) <= 3).
  • Able and willing to sign informed consent.
  • Age ≥ 18 years old at the time of study entry.
  • Alcohol consumption < 2 drinks/day for men and <1 drink/day for women
  • Hepatitis B surface antigen (HBsAg), Hepatitis C Virus (HCV) antibody, human immunodeficiency virus (HIV) antibody negative.
  • Serum alanine aminotransferase (ALT) < 400 microliter (uL)
  • Group 2 (NASH Patients):
  • NASH as determined by liver biopsy 3 months prior to the scan.
  • NASH defined as NAS score greater than or equal to 4 with confirmation of NASH by an anatomic pathologist.
  • Able and willing to sign informed consent.
  • Age >= 18 years old at the time of study entry.
  • Alcohol consumption < 2 drinks/day for men and <1 drink/day for women
  • HBsAg, HCV antibody, HIV antibody negative.
  • Group 3 (Healthy volunteer):
  • No known history of diabetes or liver disease.
  • Able and willing to sign informed consent.
  • Age >= 18 years old at the time of study entry.
  • Body mass index < 25.
  • Liver panel normal (aspartate aminotransferase (AST), ALT, alkaline phosphatase, bilirubin).
  • HBsAg, HCV antibody, HIV antibody negative.
  • Hemoglobin A1c < 5.7%.
  • Estimated glomerular filtration rate (eGFR) >= 60 mL/min/1.73m^2

Who cannot join

  • Part 1 (Imaging Optimization): For Cohorts 1/B only:
  • Poorly controlled hypertension, with blood pressure at study entry > 160 mmHg systolic or > 100 mmHg diastolic.
  • Congestive heart failure with New York Heart Association (NYHA) status ≥ 2.
  • Pregnant or nursing.
  • Participants unwilling or unable to undergo magnetic resonance (MR) imaging, including participants with contra-indications to MRI, such as cardiac pacemakers or non-compatible intracranial vascular clips.
  • Participant size too large to fit in MR scanner.
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  • Part 2 (Pilot Study): All groups
  • Poorly controlled hypertension, with blood pressure at study entry > 160 mmHg systolic or > 100 mmHg diastolic.
  • Current treatment with oral medication for diabetes.
  • Pregnant or nursing.
  • Participants unwilling or unable to undergo MR imaging, including patients with contra-indications to MRI, such as cardiac pacemakers or non-compatible intracranial vascular clips.
  • Participant size too large to fit in MR scanner.
  • Congestive heart failure with New York Heart Association (NYHA) status >= 2.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of California, San Francisco

    San Francisco, California, 94143

Other trials in United States

About this study

Official title: Pilot Study of Magnetic Resonance Imaging With Hyperpolarized Pyruvate (13C) In Patients With Fatty Liver Disease

The recent development of dissolution dynamic nuclear polarization (DNP) technology for hyperpolarized (HP) 13C imaging offers a promising new avenue for non-invasively accessing fundamental metabolic changes associated with the progression of fatty liver disease in vivo. The purpose of this pilot study is to optimize sequence parameters for hyperpolarized 13C acquisition in the human liver and determine which metabolic changes can be seen in humans with simple, non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) when compared to healthy volunteers.

Read the detailed description

PRIMARY OBJECTIVES:

  1. Optimize scan parameters in order to maximize the signal-to-noise ratio of the HP 13C-pyruvate magnetic resonance imaging (MRI) in the liver.
  2. Determine whether the level of lactate production (as measured by the lactate/pyruvate ratio) in NASH participants, participants with simple NAFL, and healthy volunteers.

SECONDARY OBJECTIVES:

  1. Develop data analysis methods to quantify HP C-13 pyruvate MRI data.
  2. Further characterize the safety profile of HP C-13 pyruvate injections.

EXPLORATORY OBJECTIVES:

  1. Examine the impact of the dual liver blood supply on the vascular kinetics of observed hyperpolarized 13C metabolism.
  2. Improve methods of quantification and motion correction for hyperpolarized 13C acquisition, incorporating perfusion information derived from 13C Urea

OUTLINE:

Part 1: (Imaging Optimization, N=50): Participants enrolled in Part 1 will predominantly be healthy volunteers. As the protocol optimization is completed, there is a possibility that testing in using data from participants with fatty liver disease may be performed. Participants in this part will be divided into two cohorts:

  • Cohort A: Participants will undergo MRI but no injection of hyperpolarized 13C.
  • Cohort B: Participants will receive one HP 13C injection. Participants in this cohort will have the option of undergoing repeated dose imaging studies of HP 13C-pyruvate or HP 13C-pyruvate+HP 13C-urea "copol", for up to a total of two injections per imaging visit.

Part 2: (Pilot Study, N=30): Participants enrolled in Part 2 will receive the HP 13C-pyruvate or HP13C-pyruvate+HP13C-urea "copol" protocol that was optimized in Part 1 as well as standard liver MRI pulse sequences. Participants will be stratified into the following groups based on diagnosis:

  • Group 1 (n=10): Participants with a diagnosis of non-alcoholic fatty liver without steatohepatitis (NAFL)
  • Group 2 (n=10): Participants with a diagnosis of non-alcoholic steatohepatitis (NASH)
  • Group 3 (n=10): Participants with no known liver disease (healthy volunteers)

Participants will be followed for 2-4 days following imaging procedure.

Being tested
Hyperpolarized (HP) 13C, Hyperpolarized 13C-Urea, Magnetic Resonance Imaging, Saline Flush
Medical subject headings
Non-alcoholic Fatty Liver Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hyperpolarized (HP) 13CDrug

    Also called HP 13C

    A dosage of 0.43 mL/kg body weight at the maximum dosage will be injected intravenously at a rate of 5 mL/second.

  • Hyperpolarized 13C-UreaDrug

    Also called HP13C-urea, copol

    Given intravenously (IV)

  • Magnetic Resonance ImagingProcedure or surgery

    Also called MRI, MR

    Imaging procedure

  • Saline FlushProcedure or surgery

    A 20 milliliter (mL) saline flush at 5 mL/second will be given after each dose of HP 13C

Study groups in NCT06176079
Study groupRoleWhat they receive
Part 1 (Cohort A): No injection of hyperpolarized (HP) 13CParticipants who are comprised of, primarily, healthy volunteers will undergo a standard MRI scan.
Receives: Procedure: Magnetic Resonance Imaging
Part 1 (Cohort B): Injection of hyperpolarized (HP) 13C or HP13C-pyruvate+HP13C-urea "copol"Participants will receive HP 13C injection, and receive an MRI scan. Imaging results will be used to optimize the hyperpolarized 13C part of the imaging procedure. Participants will also have the option of undergoing repeated dose imaging studies of HP 13C-pyruvate or HP13C-pyruvate+HP13C-urea "copol", (up to a total of two injections per imaging visit separated by 15-60 minutes). Participants may be asked to fast up to 6 hours prior to the scan and the initial HP 13C MRI scan may be taken while participants are in a fasted state. Participants who have fasted will be offered up to 20 ounces (oz) of an oral glucose, fructose, or other high calorie drink (i.e. Gatorade, Coca-Cola, Ensure, etc.) to increase blood glucose levels, and a second HP 13C MRI scan will be performed after caloric intake.
Receives: Drug: Hyperpolarized (HP) 13C; Drug: Hyperpolarized 13C-Urea; Procedure: Magnetic Resonance Imaging; Procedure: Saline Flush
Part 2 (Group 1): NAFLDParticipants with diagnosed NAFLD will receive HP 13C-pyruvate or HP13C-pyruvate+HP13C-urea "copol" injection optimized in Part 1 of the study as well as standard liver MRI pulse sequences.
Receives: Drug: Hyperpolarized (HP) 13C; Drug: Hyperpolarized 13C-Urea; Procedure: Magnetic Resonance Imaging; Procedure: Saline Flush
Part 2 (Group 2): NASHParticipants with diagnosed NASH will receive HP 13C-pyruvate or HP13C-pyruvate+HP13C-urea "copol" injection optimized in Part 1 of the study as well as standard liver MRI pulse sequences.
Receives: Drug: Hyperpolarized (HP) 13C; Drug: Hyperpolarized 13C-Urea; Procedure: Magnetic Resonance Imaging; Procedure: Saline Flush
Part 2 (Group 3): Healthy VolunteersHealthy volunteers without known liver disease will receive HP 13C-pyruvate or HP13C-pyruvate+HP13C-urea "copol" injection optimized in Part 1 of the study as well as standard liver MRI pulse sequences.
Receives: Drug: Hyperpolarized (HP) 13C; Drug: Hyperpolarized 13C-Urea; Procedure: Magnetic Resonance Imaging; Procedure: Saline Flush

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Optimal coil placement (Part 1)

    Establishing suitable radiofrequency (RF) coils for individual applications and proper use of MRI techniques such as parallel imaging to achieve optimal image quality will be conducted during the participant's scan. There is no formal analytic plan for Part 1 of the study, which is focused on optimizing the image acquisition protocol.

    Measured: 1 day

  2. Optimal pulse sequences (Part 1)

    Establishing the pulse sequences for individual applications and proper use of MRI techniques such as parallel imaging to achieve optimal image quality will be conducted during the participant's scan. There is no formal analytic plan for Part 1 of the study, which is focused on optimizing the image acquisition protocol.

    Measured: 1 day

  3. Optimal respiratory parameter (Part 1)

    Establishing the magnitude of respiratory motion for individual applications and proper use of MRI techniques such as parallel imaging to achieve optimal image quality will be conducted during the participant's scan. There is no formal analytic plan for Part 1 of the study, which is focused on optimizing the image acquisition protocol.

    Measured: 1 day

  4. Mean lactate/pyruvate conversion rate (kPL) (Part 1, Cohort B)

    Mean lactate-to-pyruvate conversion will be calculated with 95% confidence intervals.

    Measured: 1 day

  5. Signal-to-noise ratio (SNR) (Part 1, Cohort B)

    SNR will be calculated..

    Measured: 1 day

  6. Mean lactate-to-pyruvate ratio (Part 2)

    The mean lactate-to-pyruvate ratio will be calculated for each of the diagnostic groups: (1) NAFL without steatohepatitis, (2) NASH, and (3) healthy volunteers.

    Measured: 1 day

  7. Mean kPL(Part 2)

    The mean kPL will be calculated for each of the diagnostic groups: (1) NAFL without steatohepatitis, (2) NASH, and (3) healthy volunteers.

    Measured: 1 day

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Dec 2023
  2. Study start22 Jul 2020
  3. Primary completion28 Aug 2025
  4. Study completion28 Aug 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
44 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06176079
Sponsor's protocol ID
19-29381
Other IDs
5R01DK115987
Status last verified
Jun 2026
First submitted
10 Dec 2023
Last updated
3 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Non-Alcoholic Fatty Liver Disease and Non Alcoholic Fatty Liver, run by Michael Ohliger, MD PhD at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 30 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 3 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Optimal coil placement (Part 1) (time frame: 1 day). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Aug 2026.

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