MR imaging of pancreatic islets: tracking isolation, transplantation and function

The increasing global incidence of diabetes and advancements in clinical pancreatic islet transplantation for the treatment of Type I diabetes have renewed the interest in understanding the variations of beta cell mass and function relative not only to transplant outcome but also to the onset and progression of diabetes. A deeper comprehension of the molecular and cellular processes involved in pancreatic islet inflammation and cytotoxicity is necessary to further improve efficacy of islet transplantation and to develop new therapies aimed at preserving beta cell function in pathological conditions. Available diagnostic methods based on metabolic response are unsuitable as they lack correlation to islet mass, viability and function. Great emphasis has been placed on developing noninvasive imaging technologies which enable the tracking of both endogenous and transplanted islet mass and potentially function overtime, the characterization of changes in islet vasculature and the degree of T-cell infiltration during insulitis. Among the more relevant modalities are magnetic resonance, positron emitted tomography, single photon emission computed tomography, bioluminescence and fluorescence optical imaging. This review focuses on the most recent advancements in magnetic resonance imaging (MRI) of pancreatic islets. In-vitro approaches aimed at characterizing the potency of isolated islets as well as in-vivo advancements in the assessment of transplanted beta cell mass are presented together with the significant progress made in the in-vivo imaging of the endocrine pancreas and islet vasculature and inflammation. Different experimental approaches are compared via their advantages and limitations with respect to their clinical implementation.