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The power of sharing: MRI-facility as a linking pin between nutrition and patient research

A new MRI-scanner was installed in Gelderse Vallei Hospital in Ede in November 2020. This hyper-modern device provides a new impulse for the fruitful collaboration between the hospital and Wageningen University & Research.

MRI is short for Magnetic Resonance Imaging, a method used to ‘look inside’ the human body through images that provide information on soft tissues in the body part that is being examined. A major advantage is that this type of imaging does not require the use of harmful radiation.

MRI’s are available in a wide range of sizes and builds and are found in numerous Dutch hospitals. The MRI-facility in Gelderse Vallei Hospital in Ede (acronym ZGV), however, is exceptional. The facility is shared by the hospital and Wageningen University & Research (WUR). Both institutes use the machine: the hospital to diagnose patients and WUR for its scientific (nutrition) research. In doing so, the institutes collaborate closely.

The MRI is, in fact, owned by Shared Research Facilities (SRF), a department within WUR that focuses on the shared use of advanced research equipment by parties within and outside of the knowledge institute. SRF invests in expensive research equipment, but only when it is made available for shared use. Thus, the new MRI was acquired. The facility is available for users from (knowledge) institutes and businesses. This provides them with access to a research facility they would otherwise not have been able to fund.

The MRI is a valuable tool in our nutrition research, allowing us to gain even more insight into how eating disorders work and how obesity occurs.
Paul Smeets, senior researcher at Wageningen University & Research’s Human Nutrition and Health Department

One such researcher who is delighted with the new device is Paul Smeets, a senior researcher at Wageningen University & Research’s Human Nutrition and Health Department. ‘We conduct nutrition research in the broadest sense’,  he states. ‘In doing so, the MRI is a valuable instrument. It allows you to analyse all sorts of things at an individual level, such as the metabolism of fat or the digestive system’s workings. However, once you are able to link different findings together, it really becomes interesting. For example, you can observe how a subject’s brain responds to food stimuli, and analyse how this impacts their eating behaviour.

This provides a better insight into the dynamics behind eating disorders or obesity, for example.’ The knowledge generated through this research can be applied in the development of innovative food products. Smeets: ‘Together, we can thus contribute significantly to addressing different societal challenges.’

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The new scanner is a Philips Ingenia Elition X, boasting a 3 Tesla magnetic field strength. The device is a significant improvement on the previous MRI, according to Smeets. The last MRI was nine years old. ‘Technical innovations move fast in this field’, he says. ‘Compared to the old machine, this MRI yields images with a higher resolution, at a lower exposure time.’ Moreover, there are many possibilities to design and apply new scanning techniques. Smeets: ‘This new MRI will allow us to, for example, study how proteins are broken down in the stomach, something that was impossible with the previous device.’

The high resolution and other technical improvements are also relevant to patient research, says Gerlinda Reijnoudt. As department manager at Gelderse Vallei Hospital, she is closely involved in the new MRI’s procurement. The new device will help radiologists in ZGV make more accurate diagnoses, she explains. ‘This MRI shows a great deal more detail, which leads to a more accurate assessment of the issue.’

The hospital will deploy the MRI in sports-related injuries, both in amateur and elite athletes. The new MRI makes it possible to better see cartilage and joints and allows the cartilage structure to be analysed. Sports-related health care at ZGV takes shape through Sports Valley and in collaboration with the Expert Centre for Sports Radiology. This contributes to the support of the Dutch (elite) sports.

Running an MRI-scan of a patient suspected of suffering from prostate cancer eliminates the need for biopsies.
Gerlinda Reijnoudt, department manager at Gelderse Vallei Hospital

Besides, the new facility will be used for prostate diagnostics that require a 3 Tesla scanner. Reijnoudt: ‘The national guideline states that prostate screening requires a 3 Tesla scanner, as this provides the resolution needed to distinguish affected tissue from healthy tissue. Running an MRI-scan of patients suspected of prostate cancer eliminates the need for biopsies or makes taking the biopsies more accurate. Naturally, this is beneficial to the patient.’

Through its collaboration with Wageningen, the hospital has access to a facility that otherwise wouldn’t have been available. ‘We are exceptionally pleased that WUR managed to procure this MRI with help from Gelderland Province and the Ministry of Economic Affairs and Climate,’ Reijnoudt says. ‘Autonomously acquiring an MRI in this technical range would otherwise have been difficult for Gelderse Vallei Hospital.’

She adds that the benefits range far beyond better diagnoses resulting from improved scanning. ‘This also fosters an excellent form of knowledge sharing. Our laboratory staff and operators are confronted with scientific experiments requiring different methods and with different purposes, which increases their expertise. This has a positive impact on the professionalism of the team as a whole.’

Extraordinary collaboration between hospital and university

The acquisition of the new MRI is part of an ongoing collaboration between the hospital and WUR. The parties have collaborated for years, especially in the domain of nutrition. This resulted in the Nutrition & Healthcare Alliance’s founding, located in Gelderse Vallei Hospital. The alliance aims to facilitate the exchange of knowledge and the collaboration between ZGV and WUR.

‘Over ten years ago, close ties between ZGV and WUR were initiated. The MRI-facility was one of the first major trajectories’, Menrike Menkveld-Beukers, director of the collaboration, states. ‘Attention for nutrition in health care increased, also as a result of (ex)cancer patients wanting to know what food would be best during and following their treatment. The hospital, with its focus on nutrition, and Wageningen scientists seeking ways to test their nutrition research in practice; it turned out to be a golden combination.

This also led to the joint MRI. ‘Really something special’, Menkveld-Beukers stresses. ‘Ideas for collaboration are not all that special, this happens all the time. But having these ideas culminate in a concrete project spanning many years and costing millions, is… well, unusual. Both organisations had a huge degree of trust and commitment, and having this new, advanced, equipment actually here proves this trust is still undiminished.’

With the arrival of this new MRI, we may well have the world’s technically most advanced facility for this type of research.
Menrike Menkveld-Beukers, director of the Nutrition & Healthcare Alliance

Over the years, the collaboration surrounding the MRI has intensified, and currently encompasses much more than merely sharing a technical facility, Menkveld-Beukers underlines. The Smell and Taste Centre is the most notable example. This multidisciplinary medical centre of expertise unites ZGV medical doctors and researchers from WUR’s Human Nutrition and Health department. In this centre, patients with an olfactory or gustatory disorder are diagnosed. The MRI plays a crucial role in this process, she explains. ‘An olfactometer and gustometer can be deployed during the scanning process, to expose the patient to certain scents or flavours. The MRI allows you to see if the subject’s brain responds.’ Menkveld-Beukers adds that research of this type can only be conducted in a few locations across the globe. ‘With the arrival of this new MRI, we may well have the world’s technically most advanced facility for this type of research.’

Research using the MRI on patients with a diminished sense of smell shows that exposure to certain scents still generates brain activity.
Menrike Menkveld-Beukers, director of the Nutrition & Healthcare Alliance

The value of the MRI in olfactory and gustatory research can hardly be overstated, says Menkveld-Beukers. ‘Research using the MRI on patients with a diminished sense of smell shows that exposure to certain scents still generates brain activity. Scent is apparently still being processed in the brain. Results such as these may well contribute to the treatment of loss of smell, an affliction that is much more prevalent than people realise. An advanced MRI is an indispensable tool.’

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The research conducted by the Smell and Taste Centre draws attention and acclaim within the medical domain, proven by the fact that treatment is covered by the health insurance companies. Moreover, COVID-19 has given this research a boost. Menkveld-Beukers: ‘The impact of corona on taste and smell, as is seen in many patients, demands further investigation. The Taste and Smell Centre and the new MRI-facility are called upon for this research.

Shared use makes facility affordable

Shared Research Facilities (SRF) played an essential role in the acquisition of the new MRI. This WUR department focuses on the collective use of research equipment and facilities. Manager Petra Roubos is responsible for the department. ‘SRF inventories the need for high-value research facilities. We link parties inside and outside of WUR who have similar needs. While the acquisition of specialised equipment generally exceeds their individual financial carrying capacity, SRF is able to invest.’ This investment is made under the condition that the equipment is made available to other organisations. ‘Sharing the equipment limits the costs for every individual party.’

This concept has been put to practice for over a decade, with the support of funders such as Gelderland province and the Ministry of Economic Affairs and Climate Policy. ‘The acquisition of the first MRI was also thus funded. With the new, advanced 3 Tesla MRI, the facility is now future-proof.’

Sharing equipment and facilities proves successful and is a crucial part of the Foodvalley 2030 innovation programme. ‘In this programme, we collaborate closely with Foodvalley NL. The funding made available for this programme by Gelderland Province provides an extra impulse to our ambition to provide even more parties with access to advanced equipment and facilities.’

Christianne van der Wal is the delegate for Economic Affairs for Gelderland province. ‘To increase the region’s attractiveness, we have worked towards an ambitious programme, Foodvalley 2030, to safeguard our position amongst the global leaders of knowledge and innovation in the domain of nutrition. Investing in shared research facilities provides both science and businesses with access to state-of-the-art equipment’, Van der Wal states. ‘This includes smaller businesses that would normally not be able to invest in equipment of this kind.’

Advanced research equipment such as the MRI is invaluable to groundbreaking innovations and is also crucial to the province. ‘Thus, we can contribute to the societal challenges we all face, such as access to healthy, sustainably produced nutrition and a clean living environment.’

Accessibility to equipment is a key consideration for the province, particularly as the investments are made with tax-payer money. Van der Wal: ‘The condition set by the province is that businesses, especially in the trade and industry sector and start-ups, have access to this equipment, as well as to support and training from experts. I hope that the available facilities, this MRI included, will be increasingly used by these businesses. Through our work towards an excellent ecosystem, which is accessible to businesses, we hope to accelerate innovations. Thus, Gelderland works on the economy of the future.’

Tailored solutions for different users

One of the businesses that have been using the MRI-facility in Ede for several years now is Alpha.One, a marketing company affiliated to the Erasmus University. This business operates within the interface between neuro-sciences and marketing. ‘We use insights from neuro-sciences to predict how consumers may respond to, for example, an advertisement or product packaging’, says Mayca Thijssen, research manager at Alpha.One.

How subjects react to stimuli, such as pictures or videos, is studied with brain scans. ‘We introduce a particular packaging to see how the brain responds’, Thijssen explains. ‘The advantage of this method is that it allows us to discern between the conscious and subconscious reaction, which are known to sometimes differ. If you ask a subject how they feel about something, you may get a socially desirable answer, or an answer influenced by how the question is formulated. Studying brain activity this can largely be avoided.’Being able to use the MRI is of great value to Alpha.One, says Thijssen. ‘Most MRI’s are not available to external researchers, and buying our own device is not an option. This facility in Ede provides a solution. And, we have an excellent relationship with Gelderse Vallei Hospital and with Wageningen University & Research. Several of our employees were even trained to use the MRI independently.’

There is much enthusiasm at Alpha.One about the new, modern MRI. ‘The higher the resolution, the more accurate the results’, says Thijssen. ‘We look forward to discovering how all the new options this device offers can help us hone our research.’

The MRI-facility fosters sharing of knowledge.
Petra Roubos, manager of the department Shared Research Facilities (SRF)

In addition to Alpha.One, various other businesses, hospitals and knowledge institutes use the MRI regularly or intermittently. The scanning facility is available to all, says Paul Smeets, who not only uses the facility for his own research but also supervises external parties wanting to use the MRI-facility. ‘It’s more than simply a machine that takes pictures’, he laughs. ‘So, we start off by deciding what the machine is to be used for, what we want to measure and what scan sequence this requires. Then, how can we best facilitate this? This lowers the threshold for using a machine of this complexity. Everyone is welcome.’

A shared-use system is not only financially beneficial to the users’, Petra Roubos of SRF adds. ‘The MRI-facility also fosters much sharing of knowledge. The way one knowledge institute uses the machine may well be of interest to other parties. Or, there appears to be some overlapping in research, which leads to collaboration. Naturally, it is possible to conduct confidential research, as well. Still, in general, you see a shared knowledge hub develop around a state-of-the-art facility such as this. That is also the purpose of our approach.’ This far exceeds just the institutes and businesses in Gelderland province. ‘The way we have been operating over the past years appears to work well for many different parties. Parties throughout the broader region see the added value and have found their way to us. This is something we are proud of, and we hope to make a valuable contribution to the development of the innovation ecosystem.’

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The investment in the new MRI-facility was made possible by Gelderland Province and the Ministry of Economic Affairs and Climate Policy.

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