Evaluation of outcome and therapeutic efficacy using Magnetic Resonance (MR) imaging remains complex for Multiple Sclerosis (MS) patients. Clinical assessment is based on evaluation of changes in brain structure and/or cognitive improvements, which may happen at a later time during treatment. Therefore, patients can be treated for months without knowing if the chosen therapeutic approach is optimal for them. Furthermore, predicting outcome remains challenging.
One of the main drivers of MS progression is neuroinflammation. Consequently, being able to image neuroinflammation would be beneficial to patient-specific prediction of outcome and treatment choice. However, to date, no imaging approach can detect neuroinflammation in vivo. We propose to address this specific problem by developing innovative neuroimaging methods based on the hyperpolarized 13C MR technology that can provide unprecedented information on a specific type of immune cells, namely macrophages. We use this innovative method to monitor the level of neuroinflammation and differentiate between macrophages that contribute to formation of lesions, from the ones that promote regeneration and repair of the damaged tissues. Knowing the status of macrophages inside an MS lesion – or in the entire brain and spinal chord – would be of high interest for diagnosis, prognosis and development of new therapeutic strategies.