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

Prior treatment

• Current treatment with oral medication for diabetes.

Other illness

• 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.
• 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.
• Poorly controlled hypertension, with blood pressure at study entry \> 160 mmHg systolic or \> 100 mmHg diastolic.
• 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.
• Congestive heart failure with New York Heart Association (NYHA) status \>= 2.

Other

• Part 1 (Imaging Optimization): For Cohorts 1/B only:
• Pregnant or nursing.
• Participant size too large to fit in MR scanner.
  • Part 2 (Pilot Study): All groups
• Pregnant or nursing.
• Participant size too large to fit in MR scanner.

• 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:
  • 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