Imaging Techniques

Microstructural Imaging: Understanding Tumors in Detail

To better understand cancer, it is often not enough to simply look at the size and location of a tumor. The internal structure of tumor tissue is also crucial: How are cells, blood vessels, and connective tissue organized? How does the tumor alter its environment? And how does this interaction influence growth, spread, and response to therapy?

The Microstructural Imaging research group develops methods and models that make such micro- and ultrastructures visible and measurable—preferably non-invasively and in living organisms. Based on this, we aim to better understand biological processes in tumors and develop new imaging markers for clinical use. This knowledge can help create new treatment strategies and better evaluate the success of therapies.

The DKFZ has a 7-Tesla human scanner and a 9.4-Tesla small-animal scanner available for this purpose. In addition, the group works closely with the DKFZ’s core facilities for light and electron microscopy, as well as with national and international partners both within and outside the Helmholtz Organization. 

 

Prevention and Early Detection of Cancer 

The early detection of cancer is of particular importance, as early detection is often decisive for the choice and success of treatment.

Imaging techniques play a central role in this context, as they can visualize cancers or their precursors at an early stage and in a non-invasive manner. This is particularly relevant for people with an increased risk of cancer, for example due to a genetic predisposition or other risk factors such as smoking.

For studies on preventive screening, the DKFZ primarily uses magnetic resonance imaging (MRI). For computed tomography (CT) examinations, a state-of-the-art photon-counting CT scanner is available that operates with particularly low radiation doses. By the end of 2026, two new low-field MRI systems will also go into operation, which are expected to significantly advance the development of whole-body MRI for the early detection of cancer.

Current research priorities include optimizing whole-body MRI for individuals with cancer predisposition syndromes such as Li-Fraumeni syndrome, MRI of the pancreas for the early detection of pancreatic cancer, breast MRI for the further development of imaging techniques, and the early detection of lung cancer using low-dose CT.

 

Whole-Body Imaging in Multiple Myeloma

Multiple myeloma is a cancer originating from plasma cells in the bone marrow that can lead to bone destruction, as well as the suppression of normal blood formation or kidney damage. 

Whole-body MRI and CT examinations play a crucial role in the diagnosis, staging, and prognostic assessment of multiple myeloma, as well as its precursor conditions MGUS (monoclonal gammopathy of undetermined significance) and smoldering myeloma, and in evaluating treatment response or disease progression over time: 

• CT scans allow for the detection of damage to mineralized bone and determine whether the bone matrix has been dissolved in places by the disease (osteolysis) or whether fractures have already occurred. 
• Whole-body MRI scans allow for the direct visualization of the bone marrow and the tumor cells themselves, and can detect changes that are not yet visible on CT. Thus, compared to CT, MRI makes it possible to identify relevant disease progression at earlier, preclinical stages or to better assess response to therapy.

Previous research findings and ongoing projects on multiple myeloma 

MRI examinations in patients with smoldering myeloma:

Our group has demonstrated that regular whole-body MRI examinations in patients with smoldering myeloma help to detect disease progression earlier, before so-called end-organ damage occurs.

MRI examinations in patients with relapsed and refractory multiple myeloma:

Our group was able to demonstrate that patients with advanced disease, specifically those with relapsed and refractory multiple myeloma, exhibit different patterns of disease involvement compared to newly diagnosed myeloma patients, and that MRI also plays an important role in risk stratification in this setting.

Repeatability and reproducibility of size measurements and ADC measurements:

In prospective test-retest studies, our group was able to define thresholds indicating when changes in size or ADC values with high certainty represent a change in the disease, and when changes in the measured values are likely due to differences in image acquisition or image interpretation.

Structured study evaluations for multicenter studies:

As part of several drug trials and their accompanying research programs, our department performs structured MRI evaluations in patients with multiple myeloma.

 

Arterial Spin Labeling (ASL): Visualizing blood flow—without contrast agents

Arterial Spin Labeling (ASL) is a specialized magnetic resonance imaging (MRI) technique that allows for the non-invasive assessment of tissue blood flow without the administration of a contrast agent. In this process, the body’s own water molecules in the blood are magnetically labeled and used as a natural “tracer” to quantitatively visualize tissue perfusion.

Unlike contrast-based perfusion techniques such as Dynamic Contrast Enhanced Imaging (DCE), ASL does not require gadolinium-containing contrast agents. This is particularly advantageous in cases of impaired kidney function or for repeated follow-up examinations. Since water is a freely diffusible tracer, ASL also allows physiological processes in the tissue to be directly examined and quantitatively modeled. Blood flow also plays an important role in many diseases, particularly in tumors. Changes in perfusion can provide indications of tumor activity or response to therapy. 

At the DKFZ, ASL is used and further developed to address various clinical and scientific questions. A key focus is on the examination of patients with gynecological tumors. Here, the method aims to help better characterize tumor blood flow and detect changes early on during therapy. Another focus is on the imaging of kidney transplants, where ASL enables contrast-free assessment of organ perfusion.

Current research projects include the technical optimization of ASL imaging and the development of stable quantitative imaging biomarkers for clinical application. The goal is to make functional MRI techniques such as ASL more widely applicable in personalized diagnostics and therapy monitoring.

 

Clinical Translation of Hyperpolarized 13C MRI

Hyperpolarized 13C MRI is an innovative imaging technique that can non-invasively visualize metabolic processes in tissue. Unlike conventional MRI, it not only provides anatomical information but also supplements the imaging with dynamic metabolic measurements. To achieve this, a specific substance is hyperpolarized shortly before the examination, which temporarily amplifies its MRI signal significantly. The method does not require radioactive tracers or ionizing radiation.

Clinically, hyperpolarized 13C-MRI is particularly relevant for oncological imaging. It can help better characterize tissue changes over the course of a disease and during therapy. This opens up new possibilities for monitoring cancer treatment and, in the long term, can help tailor treatment decisions more closely to individual biological characteristics.

Our contribution lies in translating this technology into clinically applicable research workflows. The focus is on standardized examination processes, quality assurance, robust measurement protocols, and the quantitative analysis of image data. The goal is to make the method reliably testable for future studies in the context of personalized medicine.

 

Quantitative Imaging

Quantitative imaging expands traditional radiological image assessment to include objectively measurable parameters. While standard procedures primarily show the size, shape, and contrast behavior of lesions, quantitative imaging enables additional characterization of tissue properties. These include, among others, diffusion and perfusion imaging, relaxometry, and MR elastography. This allows us to assess cell and tissue structure, blood flow, water and fat content, as well as tissue stiffness. These parameters are often only indirectly visible in standard images and provide information on the precise tissue composition.

Clinically, quantitative imaging is relevant in oncological diagnostics, staging, and treatment monitoring. It helps to better characterize tumors non-invasively, visualize early treatment effects, and objectively compare changes in disease progression.

Our focus is on the development, validation, and clinical application of quantitative MRI methods. The goal is to establish robust image markers that improve diagnostic decisions, make treatment effects measurable, and support more personalized oncological care.