Abstract
Magnetic resonance imaging (MRI) has the potential to improve our understanding of diabetes and improve both diagnosis and monitoring of the disease. Although the spatial resolution of MRI is insufficient to directly image the endocrine pancreas in people, the increasing awareness that the exocrine pancreas is also involved in diabetes pathogenesis has spurred new MRI applications. These techniques build upon studies of exocrine pancreatic diseases, for which MRI has already developed into a routine clinical tool for diagnosis and monitoring of pancreatic cancer and pancreatitis. By adjusting the imaging contrast and carefully controlling image acquisition and processing, MRI can quantify a variety of tissue pathologies. This review introduces a number of quantitative MRI techniques that have been applied to study the diabetic pancreas, summarizes progress in validating and standardizing each technique, and discusses the need for image analyses that account for spatial heterogeneity in the pancreas.
Highlights
Recent advances in magnetic resonance imaging (MRI) technology have improved pancreas imaging, surmounting some of the difficulties inherent to the small, irregular shape of the pancreas, and its challenging location and susceptibility to motion
To date, MRI of the pancreas has had relatively limited impact on the study or management of diabetes. This likely stems in part from the established paradigm that diabetes effects only the endocrine pancreas, or islets, which are too small to be imaged by MRI
This review focuses on quantitative MRI techniques and their application to study the pancreas in both type 1 and type 2 diabetes (T2D)
Summary
Recent advances in magnetic resonance imaging (MRI) technology have improved pancreas imaging, surmounting some of the difficulties inherent to the small, irregular shape of the pancreas, and its challenging location and susceptibility to motion. Circulating autoantibodies signify risk for T1D, but their presence can be transient and time to progression after autoantibody presentation is highly variable [8] These limitations and other aspects of diabetes care currently not well characterized by blood tests may be addressed in part by medical imaging. Quantitative MRI refers to the objective measurement of parameters derived from digital images that characterize tissue attributes [9] This contrasts with the traditional qualitative assessment typically performed in standard radiology practice. This review highlights a range of quantitative MRI parameters that may improve our understanding of the diabetic pancreas, benchmarks each technique’s progress in validation and standardization, and concludes with a discussion of image analyses that can accurately characterize pancreas heterogeneity
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