Reassessing the value of MRI T2∗ in evaluation of hepatic and myocardial iron concentration: An institutional study

Fahmy, Hadeer Safwat; Khater, Nivan Hany; Shahat, Hazem Mohamed El; Madani, Ahmed Abdelsatar; Hadidy, Samah Saleh El

doi:10.1016/j.ejrnm.2015.06.008

Cited by 15 publications

(17 citation statements)

References 26 publications

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“…Similar to our study, most of the previous studies[ 10 17 18 20 21 ] also failed to correlate serum ferritin level and T2* MRI heart (either r was <0.25 or P value was >0.05) except the study by Majd et al .,[ 16 ] who showed poor negative correlation ( r = −0.329, P = 0.002) between these two.…”

Section: Discussionsupporting

confidence: 90%

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Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children

Suthar

Goyal

Sharma

et al. 2018

Asian J Transfus Sci

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CONTEXT:T2* magnetic resonance imaging (MRI) is being increasingly used for the assessment of organ iron content in thalassemics, but cost is a major prohibitive factor for repeated measurements. If serum ferritin correlates well with the T2* MRI liver and heart, it will be economical and more simple tool to assess organ iron deposition.AIMS:The aim of this study was to find out the relationship between serum ferritin level and T2* MRI-derived liver and heart iron content in transfusion-dependent thalassemic childrenSETTINGS:Thalassemia day-care center of a teaching hospitalDESIGN:This was a cross-sectional studySUBJECTS AND METHODS:Seventy-three transfusion-dependent beta thalassemic children belonging to 2–18 years of age were subjected to T2* MRI of heart and liver to assess their iron content. Values obtained here were related to serum ferritin.STATISTICAL ANALYSIS USED:Keeping the correlation between serum ferritin and T2* MRI as primary outcome, spearman's correlation coefficient was calculated.RESULTS:We found poor (negative) correlation between serum ferritin level and T2* MRI liver (r = -0.448, P = 0.000) but no correlation between serum ferritin and T2*MRI heart (r = -0.221, P = 0.060).Conclusions:Serum ferritin cannot reliably predict the liver and heart iron content in Indian children with β thalassemia.

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Section: Discussionsupporting

confidence: 90%

“…[ 18 ] and Fahmy et al . [ 17 ] also. On the other hand, Azarkeivan et al .,[ 19 ] Kolnagou et al .,[ 20 ] and Zamani et al .…”

Section: Discussionmentioning

confidence: 99%

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Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children

Suthar

Goyal

Sharma

et al. 2018

Asian J Transfus Sci

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“…Beta-thalassemia major is a hereditary genetic disorder of hemoglobin which leads to hemolysis; an effect makes these patients need repeated blood transfusions that lead to iron overloading including the liver, heart, spleen, bone marrow, pancreas, and endocrine system [1,16,17]. Iron deposition in the heart follows a characteristic pattern; it is greater in the epicardium and more in the ventricles than the atria [3,5,9,10,16,17]. Cardiac dysfunction depends on the quantity of the deposited iron and the extent of fibers involvement.…”

Section: Discussionmentioning

confidence: 99%

“…Significant cardiac iron load can be encountered, although the hepatic iron concentration is kept low, an issue urges the need to quantify this burden, especially in a non-invasive manner in the pediatric age group [5].…”

Section: Introductionmentioning

confidence: 99%

MRI evaluation of hepatic and cardiac iron burden in pediatric thalassemia major patients: spectrum of findings by T2*

Shehata

Amin

Zidan

2019

Egypt J Radiol Nucl Med

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Background: Iron deposition distorts the local magnetic field exerting T2* signal decay. Biopsy, serum ferritin, echocardiography are not reliable to adjust iron chelation therapy. Quantified MRI signal decay can replace biopsy to diagnose iron burden, guide treatment, and follow up. The objective of this study is to evaluate the role of T2* in quantification of the liver and heart iron burden in thalassemia major patients. This cross-sectional study included 44 thalassemia patients who were referred to MRI unit, underwent T2* MRI. Results: Twenty-one male (47.7%) and 23 female (52.3%) were included (age range 6-15 years, mean age 10.9 ± 2.9 years). Patients with excess hepatic iron show the following: 11/40 (27.5%) mild, (13/40) 32.5% moderate, and (14/40) 35% severe liver iron overload. High statistical significance regarding association between LIC and liver T2* (p = 0.000) encountered. Cardiac T2* values showed no relationship with age (p = 0.6). Conclusion: T2* is a good method to quantify, monitor hepatic and myocardial iron burden, guiding chelation therapy and prevent iron-induced cardiac complications.

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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

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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.

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Reassessing the value of MRI T2∗ in evaluation of hepatic and myocardial iron concentration: An institutional study

Cited by 15 publications

References 26 publications

Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children

Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children

MRI evaluation of hepatic and cardiac iron burden in pediatric thalassemia major patients: spectrum of findings by T2*

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

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