New scan could help establish who would benefit most from islet cell transplantation

Scientists from Yale University have developed a test to help establish whether people with type 1 diabetes are suitable for islet cell transplantation.
The test involves a brain scan which is used to assess a person’s beta cell mass, establishing the percentages of functional and non-functional, insulin-producing beta cells. This is useful information because someone with few viable or dormant beta cells could be suitable for islet cell transplantation.
Islet cell transplantation involves taking islet cells from the pancreas of a donor and implanting them in the liver of someone with type 1 diabetes. This can help people with type 1 diabetes reduce their dependency on insulin, and even go for months or years without needing external insulin.
The Yale technology uses positron emission tomography (PET) imaging. In laboratory test the researchers scanned brain radioligands – the activity in neurological tissue – to assess if they could identify beta cells. They screened radioligands because they have common cellular receptors and transporters to beta cells.
Then, 12 people without type 1 diabetes and two with the condition received PET and a computed tomography (CT) scan. One radioligand in particular demonstrated potential markers of beta cell mass.
Dr Jason Bini, of the university’s Connecticut-based PET Center, said: “This work is important for patients because uptake of a radiotracer measured on a PET scan could guide treatment options. For example, if a patient has low beta cell function with high signal in the PET scan, this could represent a patient with dormant beta cells that could respond to a treatment targeting existing cells.
“These findings could facilitate development and wider dissemination of novel imaging methods in molecular imaging and nuclear medicine to assess receptor/enzyme pharmacology in diabetes and other endocrine disorders.”
Further research is needed before the PET test can be assessed in clinical trials, but researchers say it is a promising method of differentiating beta cell mass, as well as guiding treatments for people with type 1 diabetes.
The findings were published in the latest edition of The Journal of Nuclear Medicine.