MRI-based ID of the Vasculature across the Heart-Brain Axis

Microvascular impairment is a hallmark of many of todays most burdening diseases, including forms of ischemic heart disease, stroke, and dementia. It is also the most promising candidate to explain the link between cardiovascular and brain disease (so-called heart-brain axis). However, only histology provides comprehensive assessment of the microvasculature, and is rarely available in vivo as it requires invasive biopsy. The lack of early, non-invasive markers limits our pathophysiological understanding and crucially affects treatment success, as preventive intervention is the only successful clinical management strategy available.With a major leap in Magnetic Resonance Imaging (MRI) physics, I will address this need and develop VascularID, a fully non-invasive toolset for the quantitative assessment of cardiac and cerebral microvasculature. This non-invasive biopsy exploits microscopic magnetic fields around the vessels to obtain structural information about the microvasculature. It is contrast-free and resilient against field inhomogeneities and can, for the first time, be used in both the heart and the brain. Combined with a new generation of non-contrast perfusion MRI, VascularID will provide comprehensive functional and structural information.My approach will first be validated in a micro-printed 3D model of the vasculature. In vivo feasibility will be demonstrated in an animal model. Proof-of-principle studies with VascularID in a cohort of patients suffering from heart disease and a cohort of patients with cerebral small vessel disease will demonstrate the clinical feasibility.I will develop, validate, and disseminate VascularID for research and clinical use to enable groundbreaking insights into the smallest blood vessels. These insights are perfectly poised to provide the missing key to the vascular underpinnings of diseases that form the major burden to our health care system in the years to come.