Muscle imaging can be performed with a variety of techniques, plain X-ray, ultrasound, CT, scintigraphy, NMR. Among these, NMR is unique in the sense that it can be used to study muscle anatomy (with standard MRI protocols), muscle physiology (with functional MRI) and muscle biochemistry (with NMR spectroscopy) during one single examination. In addition, muscle intrinsic contrast with MRI is incomparably richer than with other techniques and it can be manipulated to sensitize signal specifically to many different variables, from fat or fibrosis to perfusion and oxygenation. As far as imaging of cell and gene therapy is concerned, innovative solutions are actively being searched using in vivo fluorescence, bioluminescence, SPECT and PET. Of course, NMR also plays an active role in the field but cannot pretend superiority, mainly because of lower sensitivity of labelling with NMR contrast agents. Nevertheless, specific areas of applications may emerge in favour of NMR, such as perhaps monitoring the fate of therapeutic cells in vivo. Due to their huge potential pre-clinical and clinical impact, such high risk projects deserve to be pursued and are integral part of our muscle imaging program.
