Comparison of Tissue Elastography With Magnetic Resonance Imaging T2* and Serum Ferritin Quantification in Detecting Liver Iron Overload in Patients With Thalassemia Major

Pipaliya, Nirav; Solanke, Dattatray; Parikh, Pathik; Ingle, Meghraj; Sharma, Rachana; Sharma, S.; Sawant, Prabha

doi:10.1016/j.cgh.2016.08.046

Cited by 14 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thalassemia patients with excess iron load and hepatitis infection, liver fibrosis was not only due to iron toxicity but also infection such as hepatitis provided a major contribution. 55–57 In contrast to the study by Pipaliya et al, 13 a weak correlation in this study was predicted because of difference in MRI methods used. In the study by Pipaliya, 13 MRI T2* was used.…”

Section: Discussioncontrasting

confidence: 93%

“… 55–57 In contrast to the study by Pipaliya et al, 13 a weak correlation in this study was predicted because of difference in MRI methods used. In the study by Pipaliya, 13 MRI T2* was used. Besides, variation of patient populations especially in subjects with TM might influence the results.…”

Section: Discussioncontrasting

confidence: 93%

“…Liver elastography is used to measure liver fibrosis since it is a non-invasive method and correlates well with the degree of fibrosis. 13–15 This method is a vital tool that can be added to the armamentarium of assessing chronic liver injury due to iron overload. The examination can be performed bedside, using a portable machine, and provide instantaneous results.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Correlation of Serum Ferritin and Liver Iron Concentration with Transient Liver Elastography in Adult Thalassemia Intermedia Patients with Blood Transfusion

Atmakusuma

Lubis

2021

JBM

View full text Add to dashboard Cite

Introduction Iron overload is a common feature of thalassemia intermedia due to regular blood transfusion and increased gastrointestinal iron absorption. Early detection and adequate iron chelator can decrease morbidity and mortality from iron overload. Liver iron concentration (LIC) by MRI T2* is the best non-invasive way to measure body iron stores. However, this method is expensive and not available nationwide in Indonesia. The aim of this study was to identify liver iron overload and correlation of transferrin saturation, serum ferritin, liver MRI T2* and LIC with transient liver elastography in adult thalassemia intermedia patients. Methods This is a cross-sectional study of 45 patients with thalassemia intermedia with blood transfusion and with and without iron chelator therapy. The study was conducted at Cipto Mangunkusumo Hospital from August through October 2016. We performed measurements of transferrin saturation, serum ferritin level, transient liver elastography and liver MRI T2*. Pearson and Spearman correlation tests were used to evaluate the correlation between transient liver elastography with transferrin saturation, serum ferritin, liver MRI T2*and LIC. Results and Discussion This study showed that 64.4% of study subjects are β-Hb E thalassemia intermedia. Furthermore, 84.4% of study subjects have regular transfusion. Based on liver MRI T2*all subjects suffered from liver iron overload, 48.9% had severe degree. Median value of liver MRI T2* was 1.6 ms. Mean serum ferritin was 2831 ng/mL, with median transferrin saturation of 66%. Mean of LIC corresponding to liver MRI T2* and mean liver stiffness measurement was 15.36±7.37 mg Fe/gr dry weight and 7.7±3.8 kPa, respectively. Liver stiffness correlated with serum ferritin ( r =0.651; p=0.000), liver MRI T2* ( r =−0.357; p=0.016), and LIC ( r =0.433; p=0.003). No correlation was found between liver elastography and transferrin saturation ( r =0.204; p=0.178). Conclusion Serum ferritin, liver MRI T2*and LIC correlated with liver elastography. No correlation was found between transferrin saturation and liver elastography.

show abstract

Section: Discussioncontrasting

confidence: 93%

Section: Discussioncontrasting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation of Serum Ferritin and Liver Iron Concentration with Transient Liver Elastography in Adult Thalassemia Intermedia Patients with Blood Transfusion

Atmakusuma

Lubis

2021

JBM

View full text Add to dashboard Cite

show abstract

“…It might be difficult to examine the relationship between iron overload and liver fibrosis in study cohorts with high rates of HCV infection. Interestingly, studies excluding patients with HCV infection were able to demonstrate a significant association between LSM and both LIC and serum ferritin 37–39 …”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, studies excluding patients with HCV infection were able to demonstrate a significant association between LSM and both LIC and serum ferritin. [37][38][39]…”

Section: Clinical Characteristics Associated With Liver Parameters Anmentioning

confidence: 99%

Liver complications of haemoglobin H disease in adults

Chan¹,

Mak²,

Chan³

et al. 2020

Br J Haematol

View full text Add to dashboard Cite

Haemoglobin H (HbH) disease is a type of non-transfusion-dependent thalassaemia. This cross-sectional study aimed at determining the prevalence and severity of liver iron overload and liver fibrosis in patients with HbH disease. Risk factors for advanced liver fibrosis were also identified. A total of 80 patients were evaluated [median (range) age 53 (24-79) years, male 34%, non-deletional HbH disease 24%]. Patients underwent 'observed' T2weighted magnetic resonance imaging examination for liver iron concentration (LIC) quantification, and transient elastography for liver stiffness measurement (LSM) and fibrosis staging. In all, 25 patients (31%) had moderate-to-severe liver iron overload (LIC ≥7 mg/g dry weight). The median LIC was higher in non-deletional than in deletional HbH disease (7Á8 vs. 2.9 mg/g dry weight, P = 0Á002). In all, 16 patients (20%) had advanced liver fibrosis (LSM >7.9 kPa) and seven (9%) out of them had probable cirrhosis (LSM >11.9 kPa). LSM positively correlated with age (R = 0Á24, P = 0Á03), serum ferritin (R = 0Á36, P = 0Á001) and LIC (R = 0Á28, P = 0Á01). In multivariable regression, age ≥65 years [odds ratio (OR) 4Á97, 95% confidence interval (CI) 1Á52-17Á50; P = 0Á047] and moderate-to-severe liver iron overload (OR 3Á47, 95% CI 1Á01-12Á14; P = 0Á01) were independently associated with advanced liver fibrosis. The findings suggest that regular screening for liver complications should be considered in the management of HbH disease.

show abstract

Interrelationship between liver T2*‐weighted magnetic resonance imaging and acoustic radiation force impulse elastography measurement results and plasma ferritin levels in children with β‐thalassemia major

Kaban

Damar

2021

J of Clinical Ultrasound

View full text Add to dashboard Cite

Purpose: To evaluate correlation and agreement between T2*-weighted magnetic resonance imaging (T2*-wMRI), acoustic radiation force impulse elastography (ARFIe) measurement results of liver and plasma ferritin levels (PFLs) in children with β-thalassemia major (β-TM). Methods:The study included 40 pediatric patients (aged 64-216 months; 14 girls, 26 boys) receiving blood transfusion and chelation therapy. To detect the severity of liver iron overload (LIO) and concomitant parenchymal fibrosis, T2*-wMRI and ARFI-e measurements were performed from the right lobe segments. Student's ttest, Mann-Whitney U, ANOVA, Spearman's test and ICC were used for statistical analysis.Results: After the measurements of T2*-wMRI, patients were grouped as normal in 4 (10%), mild in 11 (27.5%), moderate in 21 (52.5%), and severe in 4 (10%) cases in terms of LIO. Combined moderate and severe groups had significantly higher ARFI-e and PFL values than the combination of other groups (p = .001, p = .040). The ARFIe measurements of boys were found to be significantly higher than those of girls (p = .023). A strong negative correlation between T2*-wMRI and ARFI-e and a moderate negative correlation between T2*-wMRI and PFL were detected (p;r = 0.001;-0.606, p;r = 0.009; À0.407). A strong positive correlation was found between ARFI-e values and PFL (p;r = 0.001; 0.659). The optimal cut-off value of ARFI-e to predict liver fibrosis because of moderate&severe LIO was determined to be 1.29 M/s (80% sensitivity and 88% specificity). A moderate agreement was observed between the T2*-wMRI and ARFI-e methods [ICC: 0.680, 95% CI: (0.470 to 0.817)]. Conclusion:Given the strong correlation and moderate agreement between ARFI-e and T2*-wMRI, ARFI -e could be used to monitor LIO in children with β-TM.

show abstract

Comparison of Tissue Elastography With Magnetic Resonance Imaging T2* and Serum Ferritin Quantification in Detecting Liver Iron Overload in Patients With Thalassemia Major

Cited by 14 publications

References 26 publications

Correlation of Serum Ferritin and Liver Iron Concentration with Transient Liver Elastography in Adult Thalassemia Intermedia Patients with Blood Transfusion

Correlation of Serum Ferritin and Liver Iron Concentration with Transient Liver Elastography in Adult Thalassemia Intermedia Patients with Blood Transfusion

Liver complications of haemoglobin H disease in adults

Interrelationship between liver T2*‐weighted magnetic resonance imaging and acoustic radiation force impulse elastography measurement results and plasma ferritin levels in children with β‐thalassemia major

Contact Info

Product

Resources

About