Pancreatic perfusion modulation following glucose stimulation assessed by noninvasive arterial spin labeling (ASL) MRI

Abstract

Background More than 100 million adults in the US suffer from prediabetes or type‐2 diabetes. Noninvasive imaging of pancreas endocrine function might provide a surrogate marker of β‐cell functional integrity loss linked to this disease. Purpose To noninvasively assess pancreatic blood‐flow modulation following a glucose challenge using arterial spin labeling (ASL) MRI. Study Type: Prospective. Subjects Fourteen adults (30 ± 7 years old, 3M/11F, body mass index [BMI] = 24 ± 3 kg.m‐2). Field Strength/Sequence 3T MRI / background‐suppressed pseudocontinuous PCASL preparation with single‐shot fast‐spin‐echo (FSE) readout before and after an oral glucose challenge using either fruit juice (n = 7) or over‐the‐counter glucose gel (n = 7). Assessment Subjects were fasting prior to initiation of oral stimulation, then dynamic perfusion measurements were performed every 2 minutes for 30 minutes. We quantified absolute blood flow at each timepoint. Statistical Tests Repeated‐measures analysis of variance (ANOVA) followed by paired t‐tests to assess for a significant effect of glucose challenge on measured perfusion. Results Measured basal blood flow was 187 ± 53 mL/100g/min. A significant blood flow increase of +38 ± 26% was observed 10 minutes poststimulation (P < 0.05) and continuing until the end of the experiment. The gel stimulation provided the most consistent results, with an early rise followed by an additional later increase consistent with the known pancreatic insulin response to elevated blood glucose. Across‐subject variations in blood flow increase were partially attributable to basal flow, with a negative correlation of r = –0.84 between basal and maximal relative flow increase in the gel group. Data Conclusion ASL can be used to measure pancreatic flow in response to a glucose challenge, which could be linked to insulin release and secretion. This paradigm might be useful to characterize disorders of glucose regulation. Level of Evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;51:854–860.

Multimodal Device and Computer Algorithm–Based Monitoring of Pancreatic Microcirculation Profiles In Vivo

“…A line-scanning confocal microscopy approach was established to examine the intraislet blood flow in mice. 13 Taso et al 14 measured pancreatic flow by using noninvasive arterial spin labeling magnetic resonance imaging. Furthermore, weight-adapted ultralow-dose pancreatic perfusion computed tomography had been reported that could obtain the blood perfusion parameters including blood flow, volume, and permeability.…”

Patients with type 2 diabetes present with multiple anomalies of the pancreatic arterial tree on abdominal computed tomography: comparison between patients with type 2 diabetes and a matched control group

“…We used CT to assess pancreatic vessels rather than magnetic resonance imaging (MRI) because of the availability of CT and because of its spatial resolution. MRI could be of interest to study pancreatic perfusion using dedicated sequences of Dynamic Contrast Enhancement and software of perfusion quantification: for instance, Taso et al showed that pancreatic basal blood flow was lower in patients with type 1 diabetes than in control subjects [60]. In addition, pancreatic MRI could be of value to assess fatty infiltration of the pancreas using dedicated q-dixon sequences in order to measure the fat fraction.…”

Quantitative Magnetic Resonance Imaging of the Pancreas of Individuals With Diabetes

“…ASL has demonstrated the ability to image increases in pancreas perfusion due to secretin (70), a hormone known to induce pancreatic fluid and bicarbonate secretion. Similarly, ASL of the pancreas has measured increased pancreas perfusion in response to glucose bolus (71). A study performing ASL during hyperglycemic clamp did not detect a difference between individuals with T1D and controls (72).…”