META-scan: A non-invasive metabolic imaging tool to study treatment response


Standardized care for various diseases is gradually being replaced by individualized treatment, adjusted to the personal health profile and specific disease manifestation. Such personalized care can improve outcome, reduce side-effects and potentially reduce costs. Imaging plays a pivotal role in quantification and follow-up of disease. However, morphologic alterations detected with imaging only manifest themselves some time after treatment is initiated, and are not very specific. To optimize personalized care, imaging needs to be supplemented with more direct ways of assessing the disease and with sensitive and early indicators of the effect of treatment.

Using radioactive tracers to investigate the influx of molecules in metabolic pathways, PET has demonstrated treatment effects. Rather than relying on an exogenous tracer to study the affinity or treatment response of certain medications, specific metabolic information can be observed through magnetic resonance spectroscopic imaging (MRSI); a non-invasive technique for the direct detection of endogenous metabolites. Preclinical studies have demonstrated that MRSI of metabolism is feasible, and that observed metabolic alterations can predict treatment effects at an early stage.

Five University Medical Centres in The Netherlands (Amsterdam, Groningen, Leiden, Nijmegen and Utrecht) have joined their expertise in metabolic imaging and have been successful in getting three relevant industrial partners to create the first clinical metabolic imager to date based on nuclear magnetic resonance spectroscopy principles. By tuning the MRI system to MR sensitive nuclei other than hydrogen (i.e. 31P, 23Na, 13C, 19F) signal from water and lipids can be avoided, while using ultra-high field strength for highest sensitivity.

Philips, Tesla and MR Coils have jointly come up with a plan to build the first clinical METAbolic imager: META-scan. Innovative is the merging of accelerator technology of magnet design into the short cryostat of a clinical 3T-MRI system (resulting in ultra-high field strength (7T)) combined with proven RF body coil design of the 3T-system. This combination results in sensitivity for 31P, 23Na, 13C and 19F spins throughout the body. Combined with digital receiver coils, highest sensitivity and robustness is assured in quantitative detection of metabolism, while multi-transmit with radiative antennas assure concurrent detailed MR imaging.

The META-scan will be used in different clinical research lines: personalized radiation treatment planning using cell proliferation and oxygenation biomarkers from the META-scan; early detection of ineffective cancer treatment using proliferation and energy alterations after first dose chemotherapy; interventions in liver metabolism; energy metabolism and sodium pumping assessments during stress in cardiovascular diseases; changes in cartilage composition to guide interventions in the musculoskeletal system. In addition to the clinical research, the META-scan will enable biotechnical research lines, investigating new means of metabolic imaging, ranging from alternative means in quantum mechanical spin manipulations to the use of meta-materials and dielectric manipulations to steer the fields in MRI.

To stay within the NWO-large budget, the UMCU will make an existing MRI system available to upgrade to the META-scan. The companies involved will cover a substantial part of the engineering expenses, and the partners involved will cover running costs to enable exploring the world?s first META-scan.





Prof. dr. ir. D.W.J. Klomp

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Universitair Medisch Centrum Utrecht, Divisie Beeld, Afdeling Radiologie