Radiology: DCE-MR imaging could be useful in diabetes treatment

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Dynamic contrast material-enhanced magnetic resonance (DCE MR) combined with pharmacokinetic modeling could be useful in monitoring therapy and predicting the response of new agents in treating type 2 diabetes, according to a study published in this month's Radiology.

Chih-Wei Yu, MD, of the department of medical imaging and radiology at the National Taiwan University Hospital in Taipei, Taiwan, and colleagues used DCE-MR with pharmacokinetic modeling in coronary artery disease (CAD) patients, with and without type 2 diabetes, to evaluate pancreatic perfusion.

The study involved 50 patients who had CAD documented with angiography and who had not undergone any coronary revascularization procedures within the previous six months. None of the patients had a history of endocrine disease other than type 2 diabetes or a history of pancreatitis. The patients were classified into two groups, one with type 2 diabetes and one without diabetes.

The authors found that the Ktrans, representing the endothelial permeability and surface area of pancreatic microcirculation, was significantly higher in patients with diabetes than in the control patients without diabetes. Another microcirculatory parameter, the vp (the percentage of plasma volume in the pancreatic tissue) was significantly decreased in patients with type 2 diabetes.

The study showed a “borderline difference” in ve (the volume fraction of contrast agent in the extravascular extracellular space) between patients with diabetes and those without. It also found that the parameters describing endothelial function of the pancreatic microcirculation observed in patients with history of diabetes of 10 or more years showed a greater difference than those in patients without diabetes.

The authors concluded that the microcirculatory parameters measured with DCE-MR imaging in the pancreas were different between those CAD patients with type 2 diabetes and those without.

“This suggests that CAD patients with type 2 diabetes tend to have increased endothelial permeability and decreased microvascular volume in the pancreas,” the authors wrote. “DCE-MR imaging of the pancreas may potentially be useful in monitoring and in predicting therapeutic response to endothelium-targeted pharmacotherapy for the treatment of type 2 diabetes.”