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Morphological and functional alterations in type 2 diabetes pancreata assessed with MRI-based metrics and [18F]FP-(+)-DTBZ PET
Journal article   Open access   Peer reviewed

Morphological and functional alterations in type 2 diabetes pancreata assessed with MRI-based metrics and [18F]FP-(+)-DTBZ PET

Seyed Faraz Nejati, Faranak Ebrahimian Sadabad, Rui Ren, Yuan Huang and Jason Bini
Frontiers in endocrinology (Lausanne), Vol.16, 1724340
12/01/2025
DOI: 10.3389/fendo.2025.1724340
PMCID: PMC12756075
PMID: 41488139
url
https://doi.org/10.3389/fendo.2025.1724340View
Published (Version of record) Open Access

Abstract

ObjectiveTo determine if combining PET-derived beta-cell mass (BCM) estimates with MRI-based morphology metrics improves the prediction of beta-cell functional mass in type 2 diabetes (T2D).MethodsWe performed a retrospective analysis of 40 participants—19 T2D individuals, 16 healthy obese volunteers (HOVs), and five prediabetes individuals—who underwent [18F]FP-(+)-DTBZ PET to quantify vesicular monoamine transporter type 2 (VMAT2) density [standardized uptake value ratio (SUVR-1)], T1-weighted MRI for 3D morphology metric analysis, and an arginine stimulation test to measure acute (AIRarg) and maximum (AIRargMAX) insulin responses. Least Absolute Shrinkage and Selection Operator (LASSO) regression models identified the optimal combination of positron emission tomography (PET), MRI, and clinical variables to predict beta-cell function for the whole pancreas and its subregions.ResultsCompared to HOVs, individuals with T2D exhibited significantly reduced AIRarg and AIRargMAX. Only the pancreas body volume was significantly smaller in the T2D cohort. For the whole pancreas, a model including PET-derived SUVR-1 and a subset of clinical covariates best predicted acute beta-cell function (AIRarg). However, predicting maximum functional reserve (AIRargMAX) required the addition of MRI-based morphology metrics in combination with SUVR-1 and a subset of clinical covariates.ConclusionWe combined PET imaging of BCM and MRI morphology metrics with a robust machine learning-based variable selection method to extract useful PET- and MRI-based metrics for predicting acute and maximum insulin responses. This synergistic approach offers a novel combination of biomarkers for staging disease and evaluating therapeutic interventions.
Diabetes Insulin Pancreas magnetic resonance imaging (MRI) positron emission tomography (PET)

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