In vivo evaluation of liver function by multimodal imaging in an alcohol-induced liver injury model

Background: Visually evaluating liver function is a hot topic in hepatology research. There are few reliable and practical visualization methods for evaluating the liver function in vivo in experimental studies. In this study, we established a multimodal imaging approach for in vivo liver function evaluation and compared healthy mice with chronic alcoholic liver injury model mice to explore its potential applicability in experimental research. Methods: In vivo fluorescence imaging technology was utilized to visually represent the clearance of indocyanine green from the liver of both healthy mice and mice with chronic alcoholic liver injury. The reserve liver function was evaluated via in vivo fluorescence imaging using the Cy5.5-galactosylated polylysine probe, which targets the asialoglycoprotein receptor of hepatocytes. Hepatic microcirculation was assessed through laser speckle perfusion imaging of hepatic blood perfusion. The liver microstructure was then investigated by in vivo confocal laser endomicroscopy imaging. Finally, hepatic asialoglycoprotein receptor expression, histology, and the levels of serum alanine aminotransferase and aspartate aminotransferase were measured. Results: In vivo multimodal imaging results intuitively and dynamically showed that indocyanine green clearance [mean & PLUSMN; standard deviation (SD): 30.83 & PLUSMN;14.71, 95% confidence interval (CI): 20.3 to 41.35], the fluorescence signal intensity (mean & PLUSMN; SD: 1,217.92 & PLUSMN;117.63; 95% CI: 1,148.38 to 1,290.84) and fluorescence aggregation area (mean & PLUSMN; SD: 5,855.80 & PLUSMN;1,271.81; 95% CI: 5,051.57 to 6,653.88) of Cy5.5galactosylated polylysine targeting the asialoglycoprotein receptor, and hepatic blood perfusion (mean & PLUSMN; SD: 1,494.86 & PLUSMN;299.33; 95% CI: 1,316.98 to 1,690.16) in model mice were significantly lower than those in healthy mice (all P<0.001). Compared to healthy mice, the model mice exhibited a significant decline in liver asialoglycoprotein receptor expression (mean & PLUSMN; SD: 219.03 & PLUSMN;16.34; 95% CI: 208.97 to 230.69; P<0.001), increased serum alanine aminotransferase (mean & PLUSMN; SD: 149.70 & PLUSMN;47.89 U/L; 95% CI: 81.75 to 128.89; P=0.01) and aspartate aminotransferase levels (mean & PLUSMN; SD: 106.30 & PLUSMN;36.13 U/L; 95% CI: 122.01 to 180.17; P=0.021), hepatocyte swelling and deformation, disappearance of the hepatic cord structure, partial necrosis, and disintegration of hepatocytes. The imaging features of fluorescence signals in liver regions, hepatic blood perfusion and microstructure were biologically related to hepatic asialoglycoprotein receptor expression, serum indices of liver function, and histopathology in model mice. Conclusions: Utilizing in vivo multimodal imaging technology to assess liver function is a viable approach for experimental research, providing dynamic and intuitive visual evaluations in a rapid manner.