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  • Review Article
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MRI as a tool to monitor islet transplantation

Nature Reviews Endocrinology volume 5, pages 444–452 (2009)Cite this article

Abstract

The development of new methods for noninvasive imaging is an area of biotechnology that is of great relevance for the diagnosis and characterization of diabetes mellitus. Noninvasive imaging can be used to study the dynamics of β-cell mass and function; β-cell death; vascularity, innervation and autoimmune attack of pancreatic islets; and the efficacy of islet transplantation to remedy β-cell loss in patients with diabetes mellitus. In this Review, we focus on the application of MRI for monitoring islet transplantation and on the potential causes of islet graft failure, which are still poorly understood. Questions that have been addressed by MRI studies encompass graft longevity, and the effects of immune rejection, glucose toxic effects, and the transplanted islets' purity on graft fate. We also highlight novel technologies for simultaneous imaging and delivery of experimental therapies that aim to extend the lifespan and functionality of islet grafts. On the basis of this evidence, MRI represents a valuable platform for a thorough investigation of β-cell function in the context of islet transplantation. State-of-the-art multimodality approaches, such as PET–MRI, can extend our current capabilities and help answer the critical questions that currently inhibit the prevention and cure of diabetes mellitus.

Key Points

  • The development of new methods for noninvasive imaging can improve the diagnosis and characterization of diabetes mellitus

  • Noninvasive imaging can help to monitor the dynamics of the β-cell mass, function and death of β cells, vascularity, innervation, autoimmune activation and infiltration of pancreatic islets

  • Although islet transplantation is a promising approach, substantial graft loss can occur owing to allorejection, autoimmune attack, glucose toxic effects, mechanical stress and microvascular disruption of the islets during transplantation

  • The use of MRI to assess transplanted islets can help to optimize transplantation protocols, explore the anatomy and physiology of transplanted islets and study the immunology of islet engraftment

  • MRI has improved our understanding of immune rejection, toxic effects of glucose, the influence of transplanted islets' purity on graft fate and facilitated delivery of experimental therapies to extend grafts' lifespan

  • State-of-the-art multimodality approaches, such as PET–MRI, can extend our current capabilities and help tackle the obstacles that currently inhibit the prevention and cure of diabetes mellitus

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Figure 1: In vivo MRI of islet transplantation under the kidney capsule.
Figure 2: In vivo imaging of intrahepatically transplanted human islets.
Figure 3: Toxic effects of glucose and influence of islet purity on islet transplantation.
Figure 4: In vivo MRI scans of encapsulated pancreatic islets transplanted into pigs, a | before and b | 5 min after intraportal infusion of magnetic capsules.
Figure 5: Multifunctional imaging and delivery of siRNA to pancreatic islets.

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Authors and Affiliations

  1. Molecular Imaging Laboratory, Massachusetts General Hospital–Massachusetts Institute of Technology–Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA

    Zdravka Medarova & Anna Moore

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Correspondence to Anna Moore.

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Medarova, Z., Moore, A. MRI as a tool to monitor islet transplantation. Nat Rev Endocrinol 5, 444–452 (2009). https://doi.org/10.1038/nrendo.2009.130

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