Advanced clinical imaging for the evaluation of stem cell based therapies

ABSTRACT

Introduction: As stem cell treatments reach closer to the clinic, the need for appropriate noninvasive imaging for accurate disease diagnosis, treatment planning, follow-up, and early detection of complications, is constantly rising. Clinical radiology affords an extensive arsenal of advanced imaging techniques, to provide anatomical and functional information on the whole spectrum of stem cell treatments from diagnosis to follow-up.

Areas covered: This manuscript aims at providing a critical review of major published studies on the utilization of advanced imaging for stem cell treatments. Uses of magnetic resonance imaging (MRI), computed tomography (CT), ultrasound, and positron emission tomography (PET) are reviewed and interrogated for their applicability to stem cell imaging.

Expert opinion: A wide spectrum of imaging methods have been utilized for the evaluation of stem cell therapies. The majority of published techniques are not clinically applicable, using methods exclusively applicable to animals or technology irrelevant to current clinical practice. Harmonization of preclinical methods with clinical reality is necessary for the timely translation of stem cell therapies to the clinic. Methods such as diffusion weighted MRI, hybrid imaging, and contrast-enhanced ultrasound hold great promise and should be routinely incorporated in the evaluation of patients receiving stem cell treatments.

KEYWORDS:

• MR imaging
• pet
• us
• ct
• stem cells
• mesenchymallabeling
• cell therapy

Article Highlights

• Advanced clinical imaging can accelerate the regulatory approval of stem cell therapies by demonstrating in vivo safety and efficacy.

• A variety of imaging methods has been used to track stem cells following in vivo implantation including MRI, CT, PET, and US.

• Host tissue factors, inflammation, surgical site infection, scaffold material composition, and cell labeling can influence the imaging findings identified with clinical imaging modalities.

• Imaging protocols applicable to everyday clinical practice need to be standardized in order to ensure consistent imaging findings post-stem cell treatment.

• Novel imaging methods are currently being developed including diffusion weighted imaging (DWI), hybrid imaging, and contrast-enhanced US, with the potential to provide functional and anatomical information and to enable targeted stem cell delivery.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper is not funded.