New MRI Technique Can Detect Diabetes

MonkeyBoy writes "Researchers at Joslin Diabetes Center and Massachusetts General Hospital have unveiled a new magnetic nanoparticle based magnetic resonance imaging technique that can detect diabetes even before clinical symptoms. In mice they were able to take non-invasive images of pancreatic inflammation and its reversal for type 1 diabetes. Full article is available as a PDF from Pubmedcentral. Will we see rapid translation of these pre-clinical observations to prediction and/or stratification of type 1 diabetes and treatment of individuals with the disease? This would provide a crucially needed early predictor of response to therapy. As an added bonus it looks like the analysis was done on a Linux box too."

Comments

One word for this:

[Anonymous Coward]

Sweet!

Why not?

[SilentReallySilentUs]

Sure.. MRI should be able to scare away diabetes with the ridiculous sounds it makes..Gosh why did no one think of this before?

Before I experience symptoms

[GXFragger]

Yay! Now they can detect my Mountain Dew drinking habits and force me to go cold turkey even when I'm still in denial!

Linux box

[Anonymous Coward]

This once again proves that the OS is unimportant, and only the application matters. Who cares what OS was used to run the program that allowed this development? Certainly not the patients that benefit from it.

http://www.residentcynic.net/

MRIs gone wild

[sigmaseven]

That's fantastic, but it's going to take a lot of persuasion to get me to go near an MRI willingly after seeing its effect on nearby hospital equipment. You're only as safe as the stupidest person in the room.

Re:MRIs gone wild

[Anonymous Coward]

One place I worked, the MRI was placed in the basement, just below the main server room.
Predictably hilarious consequences happened.
Hospital management. Gotta love 'em.

Open Source Medicine?

[Khyber]

Just reading the summary, it says the box might run on Linux?

This is a good thing, now if only the pharmaceutical companies would make alot of their stuff open to the public, maybe we'd all not suffer nearly as badly due to our wallets not being fat enough.

Re:Open Source Medicine?

[Rosco P. Coltrane]

This is a good thing, now if only the pharmaceutical companies would make alot of their stuff open to the public, maybe we'd all not suffer nearly as badly due to our wallets not being fat enough.

Methink you're talking bollocks for the sake of plugging "open source" somewhere...

What "stuff" is it that pharmaceutical companies need to "open to the public"?

New medicines must be fully disclosed when they undergo FDA approval, and they always end up completely open because they're patented, and a patent describe the invention/innovation completely. If you don't believe me, ask yourself how it is that countries like India or Brazil manage to copy the very latest in AIDS therapies.

The reason you pay dearly for medicines that haven't fallen in the public domain is because yoy purchase them from the patent holders, which hold a temporary monopoly on said medicines, and therefore make you pay whatever the hell they want, to recoup their development costs and to pay for their villas in Switzerland.

In short, it's nothing to do with being open, and all to do with patents. Wrong Slashdot meme there bubba...

Re:useless!!!

[Rosco P. Coltrane]

This doesn't belong on Slashdot.

Of course it does. Given the sedentary lifestyle of many Slashdotters, it concerns them most directly.

All I know is...

[yellowbkpk]

I was just at a meeting at a meeting at a major healthcare company, and number two on the list of priorities for the next 3 years was diabetes detection/prevention. The budget was in the billions.

These guys will be making a LOT of money.

Fullfilling MRI's promise (sort of)

[IvyKing]

The original push for MRI (from Damadian) was to locate cancers - the main benefit is eliminating a lot of exploratory surgeries. In this case it eliminates the need for biopsies (which, from TFA, are rarely performed due to the risk). Very nice work.

This is an interesting application of magneto-immunoassay - using the change in magnetic properties to determine if there has been a reaction.

Get The Facts

[pin_gween]

I am posting instead of replying b/c there are already several separate posts that have it wrong. Gasp and shock, I know.

Type I diabetes is NOT associated with diet.

This article refers to an autoimmune disease, not a lifestyle induced one.

PubMed abstract

[whovian]

J Clin Invest. 2005 Aug 18; [Epub ahead of print] Related Articles, Links

        Noninvasive imaging of pancreatic inflammation and its reversal in type 1 diabetes.
Turvey SE, Swart E, Denis MC, Mahmood U, Benoist C, Weissleder R, Mathis D.

        Section on Immunology and Immunogenetics, Joslin Diabetes Center, and Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

        A major stumbling block for research on and treatment of type 1 diabetes is the inability to directly, but noninvasively, visualize the lymphocytic/inflammatory lesions in the pancreatic islets. One potential approach to surmounting this impediment is to exploit MRI of magnetic nanoparticles (MNP) to visualize changes in the microvasculature that invariably accompany inflammation. MNP-MRI did indeed detect vascular leakage in association with insulitis in murine models of type 1 diabetes, permitting noninvasive visualization of the inflammatory lesions in vivo in real time. We demonstrate, in proof-of-principle experiments, that this strategy allows one to predict, within 3 days of completing treatment with an anti-CD3 monoclonal antibody, which NOD mice with recent-onset diabetes are responding to therapy and may eventually be cured. Importantly, an essentially identical MNP-MRI strategy has previously been used with great success to image lymph node metastases in prostate cancer patients. This success strongly argues for rapid translation of these preclinical observations to prediction and/or stratification of type 1 diabetes and treatment of individuals with the disease; this would provide a crucially needed early predictor of response to therapy.

MRI

[mchawi]

I have heard from several people that have had an MRI that (a) it is almost impossible to get scheduled in any reasonable timeframe for one and (b) they are 'incredibly expensive'.

For something like diabetes that can be diagnosed in other ways, I don't see a normal doctor or health insurance company prescribing an MRI. Health care is one of the areas where capitalism is really the wrong motivation (because our long term health is not their concern - just short term costs).

I guess I'm just cynical, but I see some of these great advances being almost useless to the majority of people because they simply can't afford it or don't even have healthcare.

I keep hoping for things to change though :)

Re:MRI

[rcolquhoun]

I have heard from several people that have had an MRI that (a) it is almost impossible to get scheduled in any reasonable timeframe for one and (b) they are 'incredibly expensive'.


So is diabetes.

I am a type 1 diabetic and it costs thousands perhaps 10's of thousands per year to manage(if you include side effects, lost opportunities etc). This will be the case for the rest of my life(hopefully 50+ years, although diabetes has a major effect in shortening it).

If it can be prevented by a series of MRI's + drugs or any other treatment for that matter that costs less than say $100k if will be economic for most pre-type 1 patients(ie children) to undertake.

  - Robert

Re:MRI

[Sparr0]

Sure, if you have insurance. And if you don't, you're fucked. And if everyone had insurance... then there would be waiting lists.

Dystopia

[philovivero]

Will we see rapid translation of these pre-clinical observations to prediction and/or stratification of type 1 diabetes and treatment of individuals with the disease? This would provide a crucially needed early predictor of response to therapy.

Perhaps this wonderful new technology will be used by insurance companies to deny your child insurance before the diabetes could possibly cut into their profit margins?

Sorry. There should be a "cynic" moderation.

Extremely preminary data

[martalli]

As a doctor, I had a few observations about this
stusdy. These researchers demonstrated that an
MRI can find evidence of diabetes in mice before
the development of clinical symptoms. How does
this relate to people?

1. Practical: Type I diabetes typically develops in
children, who usually must be sedated and
observed for an MRI. This could double the cost
of the MRI (typically $1-2k in US). Also, we
don't know how long these findings are present
before diabetes develops ... how often would
this need to be done?

2. The Incidence of type I diabetes is about
0.4% among people without relatives with
type I. First degree relatives have a 5-30%
risk... Certain genes predispose to type I
diabetes.... maybe this could be used in certain
people.

3. Since there is no such early diagnosis, we
don't really know who we might treat this
pre-type I state. Certainly we could make a
few reasonable guesses, but any benefit is
still in doubt until there are human trials.

I think this will definitely be more handy when
tricorders are perfected!

Re:Extremely preminary data

[martalli]

Sometimes, a person's immune system might confuse some viral proteins with the proteins on the pancreatic beta cells (which make insulin). This leads to the immune system attacking the beta cells. Eventually no beta cells are left and a person requires insulin to replace their natural insulin production.

There is nolikely specific infection which causes diabetes. However, some viruses may be more likely to confuse the immune system. Also, your immune system's genetic makeup may predispose it to confusing the virus and the beta cells.

Insulin is required to move glucose from the bloodstream into cells. Without it, the bloodstream glucose level rises until glucose spills out into the urine. In fact, diabetes mellitus is Greek for "sweet urine". Unfortunately, diabetics are literally starving in a sea of food.

This creates more questions than it solves

[rc5-ray]

(Disclaimer: I'm a primary care doctor in the USA. I have a few type I diabetics, and many type IIs.)

First, I think it's great that the researchers have demonstrated a potential way to identify pre-clinical type I diabetes. If these patients could be easily identified and the pathologic process halted or reversed, this would be one of the greatest feats ever accomplished in medicine.

However, this approach has several problems. Another poster has already mentioned that health insurance companies could start denying coverage to kids(and adults) who don't have diabetes, but might get it. If you're a health plan administrator, diabetes is a very, very expensive disease and you want to avoid these patients.

(Whether health insurance companies should even be in the business to make a profit is a topic for another debate. Short answer: It's absolutely wrong.)

More importantly, who do you screen with MRI? Do you screen every child at age 5 (or another pre-defined age)? Do you only screen them once? It's true that most type I patients are diagnosed by the early teens, but a significant portion develop the disease in their later teens or twenties. I have a 20 year old patient who was just diagnosed with type I after the birth of her first child. I also had a medical school classmate who was diagnosed while in his residency.

Once you've decided who you'll screen and at what age and interval, how do you pay for it? This cannot be ignored. An abdominal MRI can cost $1-3,000, and you often need to sedate patients because it's quite claustrophobic. If you were to screen every child only once, the cost would skyrocket into billions of dollars almost immediately.