Magnetic Resonance Spectroscopy

Extracting metabolic information with noninvasive technology

Think fat only shows on the outside? Lidia Szczepaniak, PhD, will tell you that's not the case. Using a revolutionary research technique known as magnetic resonance spectroscopy, Dr. Szczepniak can measure the amount of fat inside an organ. The goal: to fight Type 2 diabetes—the kind that's linked to diet and that accounts for 90 percent of all diabetes cases. Not everyone who's overweight or obese goes on to develop the disease. Understanding how fat behaves inside organs may help doctors predict who's most susceptible—a big step to effective prevention.

Magnetic resonance spectroscopy is based on the same principles as magnetic resonance imaging (MRI), but goes a step further: it extracts metabolic information from the organ it's imaging. "With this technique, we're able to accurately gauge how much fat is in the liver or the pancreas," says Dr. Szczepaniak. Prior to this noninvasive technology, that could only be done by first performing a biopsy—removing a part of the organ and then investigating the fat content.

According to Dr. Szczepaniak—a physicist by training and now director of magnetic resonance spectroscopy at the Smidt Heart Institute—in chronic obesity, the adipose tissue designed to store fat begins to malfunction, so fat spills into the liver, pancreas and skeletal muscle. In some people, the pancreas can compensate by secreting more insulin, the metabolism-regulating hormone. In others, it can't. It's in these unlucky individuals that the risk of Type 2 diabetes goes up. "We believe fatty pancreas is the culprit," says Dr. Szczepaniak. "It's unable to secrete enough insulin to compensate, and the person progresses to Type 2 diabetes."

In a study, Dr. Szczepaniak and her colleagues compared African-American, non-Latino Caucasian and Latino participants. The result: Latinos were the most likely to store fat in their pancreas. "We believe this accounts for the higher rates of Type 2 diabetes among that population," says Dr. Szczepaniak.

She hopes the revolution in diagnostics will lead to the most meaningful revolution of all—effective prevention that improves and lengthens the lives of countless individuals and reverses the epidemic rise in Type 2 diabetes.