The spin doctor: Resonance between imaging and health

The power of MRI: A glimpse into the invisible

Jeanine's eyes light up as she talks about MRI. “MRI is truly a miraculous technique,” she says. “With magnetic fields and radio waves, we create detailed images of the body without cutting or using ionizing radiation.” What makes MRI unique, she says, is its ability to study not only the structure but also the function of organs. “You can use MRI to study heart function, blood flow and even metabolism. Disease often develops long before you see anything on a regular scan. It starts with subtle changes in metabolism. Even before an organ “breaks down,” it becomes unbalanced. Metabolic imaging makes these early changes visible. That provides opportunities to intervene earlier, prevent disease and better monitor treatments.”

From nuclear magnetic resonance to metabolic imaging

“The basis lies in nuclear magnetic resonance, a phenomenon discovered in the 1940s,” she explains. “Hydrogen nuclei in the body behave like tiny magnets. By disrupting their response to a magnetic field via radio waves, we can measure signals and convert them into images.” Other nuclei, such as phosphorus and carbon-13, also provide valuable information about metabolic processes. “With spectroscopy, we measure metabolites, the molecules involved in metabolism. We use the same scanner as for MRI, but instead of images we make spectra. Each peak in the spectrum represents a particular substance. So we can see which substances are in the body and in what quantities.”

Collaboration: the key to progress

Why is metabolic imaging so important, and why is collaboration with other disciplines essential? Jeanine: “Many diseases start with subtle changes in metabolism. With metabolic imaging, we can make those processes visible, often before any damage is visible on a regular scan.” She gives an example: “New treatments, such as immunotherapy for cancer, are promising, but by no means work in every patient. Yet many more patients receive such a treatment, because we cannot accurately predict in whom it will work. This is not without risk, as these treatments often have drastic side effects and are very expensive. With metabolic imaging, we can better tailor treatments to the individual patient and avoid side effects of ineffective therapies.”

Jeanine works closely with colleagues in the Department of Human Biology and in the Department of Imaging at the hospital. “Metabolism doesn't stop at the scanner. We can also study metabolism through blood, breath and tissue. That provides complementary insights. By collaborating with colleagues who use other techniques, we get an even better picture of what metabolic imaging can offer us.” She emphasizes the uniqueness of Maastricht: “Here there is a lot of attention to prevention and a personalized approach to health. We do not only look at traditional treatments, but also at prevention and vitality, lifestyle and health promotion. This is very future-oriented. Imaging alone won't get us there; we need all these other things as well. It really is a multidisciplinary approach, and I like that so much.”

Disease and metabolism: a look inside the body's power plants

The conversation shifts to the role of metabolic imaging in diseases such as type 2 diabetes, obesity, cancer and heart failure. “In diabetes, fat levels in muscle and liver increase, leading to decreased function of mitochondria, the energy power plants of cells,” Jeanine explains. “All cells need energy. This is most obvious in muscles, which use energy for movements such as walking or running. In athletes, mitochondria have a high capacity, but properly functioning mitochondria are also essential for non-athletes. Reduced function is associated with several diseases, including diabetes. Understanding the causes of this can provide clues for targeted interventions.”

She continues: “To study this, we need to be able to measure mitochondria function. Magnetic resonance offers a non-invasive method for this. This is valuable, not only to unravel disease processes, but also to evaluate the effect of therapies and understand how pathological changes can potentially be reversed.”

Technological innovations: the power of high field strength

Jeanine talks enthusiastically about the technological developments in her field. “With conventional MRI we look at hydrogen nuclei, but in metabolic imaging it is also interesting to look at phosphorus, carbon-13 or deuterium. Magnetic resonance is actually a fairly insensitive technique, especially compared to nuclear or optical imaging. Sensitivity depends on the strength of the magnet in the MRI scanner, expressed in tesla. The stronger the magnet, the higher the sensitivity.”

“In Eindhoven we used MRI scanners with field strengths of 7 and 9.4 tesla for animal studies, but no humans fit in them. In hospitals, scanners are usually 1.5 or 3 tesla, which means the sensitivity is lower. For anatomical images this is sufficient, but for metabolic imaging it becomes more difficult because metabolites occur in much lower concentrations than water. So for metabolic imaging, higher field strength is really crucial.”

An important step in her career was working with a 7 tesla MRI scanner at UMC Utrecht. “This powerful scanner enables sensitive measurements of metabolites in humans, something that was previously only possible in animals. Projects like the META scan are aimed at making metabolic imaging user-friendly in the clinic.”

Close to the clinic: from research to patient care

Jeanine's work has a clear link to the hospital and clinical practice. “Although the techniques are complex, the ambition is to make metabolic imaging more widely applicable in hospitals. The knowledge about differences in metabolism between individuals offers great opportunities for personalized medicine, where treatments are no longer 'one-size-fits-all,' but tailored to the patient's unique metabolism.”

Through her partial appointment at the hospital, she also works extensively with the radiology department at MUMC+. “The development to translate high field strength measurements to the more common clinical field strength offers nice challenges. There is a lot of interest in that from the hospital.”

One of the promising techniques Jeanine is working on is deuterium metabolic imaging (DMI). “PET scanners are now often used for cancer patients, but that involves radiation and complex logistics. Deuterium metabolic imaging could offer an alternative. With it, you can see more specifically how active a tumor is and whether immunotherapy is effective, even before a tumor becomes visibly smaller.”

She explains: “Normally you look to see if a tumor is shrinking, but that often takes a while. With this type of imaging, you can see earlier what the tumor's activity is. Sometimes in the beginning a tumor even seems to get bigger because of the treatment, we call that pseudoprogression. Then it looks like the tumor is growing, but in reality it is less active. With this technique, you can see that difference earlier.”

Healthy living, prevention and vitality: the role of imaging

We ask her how imaging can contribute to healthier living. Jeanine is resolute: “That role is crucial. If we better understand how people are metabolic and where they differ, we can work much more specifically on prevention and a healthier lifestyle. Often people only change something about their lifestyle after something has already gone wrong, such as a heart attack. But if you can show people what they look like on the inside, maybe that can help them make the switch sooner. You literally make it visual and insightful.”

The spin doctor: connector between technology, clinic and society

Finally, we ask her about the title of her inaugural address: The spin doctor. Jeanine laughs, “Through the resonance of nuclear spins in an MRI scanner, I can show metabolic processes in the body. I see myself as a connector of technology, clinic and society, where I hope metabolic imaging will gain a more prominent role in health care. If it becomes as easily applicable as conventional MRI, we can really start using it in the clinic.”

She concludes, “I hope to contribute to a healthier society with my research by providing insight into how the body works at the level of metabolism, a key system fundamental to health and disease. MRI is a versatile tool for this purpose. Visualizing metabolism at the organ level helps tremendously in prevention and personalizing health care. There is nothing more exciting than contributing to that with research!”

Interview and text: Danielle Vogt

Photo: Joey Roberts

She studied Chemistry at the Radboud University Nijmegen, where she graduated cum laude in 1994. The following years she performed a PhD project in the group of Prof. Dr. C.W. Hilbers at the Radboud University Nijmegen in the field of high-resolution protein MRS, obtaining her PhD degree in 1999. 

After her PhD, she was awarded a long-term postdoctoral fellowship from the Human Frontier of Science Program for two years of research with Prof. Brüschweiler (Clark University, USA). During this period, she studied correlated protein motions by a combined interpretation of MR relaxation data and molecular dynamics simulations. 

After her postdoc, she joined the Biomedical NMR group of Prof. Nicolay at Eindhoven University of Technology in 2002 as an assistant professor and was promoted to associate professor in 2012.  

She was associate professor at the UMC Utrecht from 2017 to 2023,  and joined Maastricht University as full professor in 2024. Her mission is to develop and apply advanced multi-nuclear MRS and MRI methods for better understanding of disease mechanisms and to provide handles for improving disease diagnostics and therapy.