Pancreatic magnetic resonance imaging after manganese injection distinguishes type 2 diabetic and normoglycemic patients

Figures & data

Figure 1. Manganese is uptaken by human islets. T1-weighted magnetic resonance images of pellets of human islets from non-diabetic multi-organ donors before (A) and after a 30 min exposure to MnCl₂ (B). C) Manganese significantly enhanced the MRI signal to noise ratio (16.0 ± 1.3 vs. 41.6 ± 0.7, p = 0.0003). Data are mean + SEM signal-to-noise ratio.

Table 1. MRI indication

Targeted organ	MRI indication	No of patients
		normoglycemic	Type 2 diabetic
liver	ear, nose and throat tumors	2	0
	melanoma	2	0
	small cell lung carcinoma	1	0
	non small cell lung carcinoma	6	0
	breast cancer	7	0
	hepatocellular carcinoma	6	0
	hepatic nodule	0	2
	hepatic abcess	1	0
	gallbladder carcinoma	1	0
	cholangiocarcinoma	6	1
	ampulloma	2	0
	esophagus tumor	1	0
	gastric adenocarcinoma	4	0
	gastrointestinal stromal tumor	3	0
	duodenal carcinoma	1	0
	terminal ileon carcinoid	2	0
	colorectal cancer	45	14
	pancreatic carcinoma	4	2
	retroperitoneal sarcoma	1	0
	nephroblastoma	3	0
	urothelial tumor	3	1
	ovarian cancer	3	0
	endometrial cancer	1	0
	testicular cancer	1	0
	diffuse non differentiated cancer	0	1
	diffuse neuroendocrine tumor	1	0
	multiple myeloma	1	0
biliary tract	fistules, leaks, post-traumatic and post-surgery indications	10	2
pancreas	carcinoma	1	1
Total number of patients		119	24

Figure 2. The MRI signal enhancement of pancreas is enhanced by manganese. T1-weighted magnetic resonance imaging showing the pancreas (area limited by the dashed line) before (A, C) and 20 min after Mn-DPDP infusion (B, D) of a normoglycemic (A, B) and a type 2 diabetic patient (C, D). In both patients, the MRI signal of pancreas was enhanced by the manganese infusion. E) This enhancement was significantly higher in normoglycemic than in type 2 diabetic patients. Data are mean + SEM signal enhancement, expressed as % of the signal evaluated prior to the manganese infusion.

Figure 3. The MEMRI enhancement of pancreas correlated with the BMI of diabetic patients. The pancreas enhancement due to Mn²⁺ was inversely correlated with the BMI (A), but not the age of the diabetic patients (B), as assessed by Pearson’s correlation.

Figure 4. The MEMRI signal of liver (A), muscle (B) and spleen (C) does not differentiate normoglycemic patients from diabetic patients. The signal enhancement of liver (A), muscle (B) and spleen (C) was not statistically different between normoglycemic and type 2 diabetic patients. Data are mean + SEM signal enhancement, expressed as % of the signal evaluated prior to the manganese infusion.