Purpose
To introduce a new comprehensive qMRI protocol for the evaluation of liver iron in multi-transfused thalassemic patients and HCV(+) patients by means of T1, T2 and T2* quantitative MRI : Preliminary results.
Methods and Materials
PatientsMR imaging studies of 40 thalassemic patients (mean age 28.55.4, median age : 27.6 yrs) 15 HCV(+) patients (mean age : 35.6 6.7 yrs, median age : 34.2 yrs) and 10 normal sublects were retrospectively reviewed. All thalassemic patients received systematic red blood cell transfusions and subcutaneous chelation with desferroxamine. Total iron burden was assessed in all thalassemic patients by means of Serum Ferritin Concentration (SFC) levels(range :900-5335 ng/ml) whereas liver iron concentration was determined in liver biopsy specimens obtained utilizing Fine Needle Aspiration (FNA)...
Results
Measurements of T2* reproducibility for different types of reference solutions have shown that aqueous solutions of Gd-DTPAprovide reproducible T2* measurements as compared with the EUROSPIN commercial reference standards. The concentration of choice for our reference was 15 mM Gd-DTPA. (CV= 6.93% for a period of one year).(Fig.12). Liver R2*(1/T2*)values were highly correlated with liver biopsy measurements (R=0.88, p< 0.0005) (Fig.13, T2* RLDF values as compared to our standard Gd-DTPA solution were highly correlated with liver biopsy estimations (R=0.85, p<0.0005). (Fig.14). Differences of liver mean T2*,R2*andT2*-RLDF...
Conclusion
Aqueous solutions of Gd-DTPA (15 mM) gave the best reproducibilityin T2* measurements for a year period of time.T2*, R2* and T2*-RLDFseem to be a valuable means for the evaluation of liver iron on 1.5 T MRI scanners. Of all measured parameters R2*gave the lowest possible p (p=0.0337) in statistical comparissonsbetween HCV(+) patients and normal subjects.
References
(1) St Pierre TG. Deferiprone versus desferrioxamine in thalassaemia, and T2* validation and utility. Lancet. 2003 Jan 11;361(9352):182; author reply 183-4.(2) Dimopoulou I, Kremastinos DT, Maris TG, Mavrogeni S, Tzelepis GE. Respiratory function in patients with thalassaemia and iron overload. 7Eur Respir J. 1999 Mar;13(3):602-5.(3) Mavrogeni SI, Maris T, Gouliamos A, Vlahos L, Kremastinos DT. Myocardial iron deposition in beta-thalassemia studied by magnetic resonance imaging. Int J Card Imaging. 1998 Apr;14(2):117-22.(4) Nagel E, Underwood R, Penell D, Sechtem UP, Neubauer S, Wickline S, Hess OM,...
Personal Information
T.G. Maris1, E. Chryssou2 O. Papakonstantinou2, N. Papanikolaou2, P. Prassopoulos2, N. Gourtsoyiannis2.(1) Medical Physics Department, University Hospital of Heraklion, University of Crete, Heraklion/Crete.email:
[email protected](2) Radiology Department, University Hospital of Heraklion, University of Crete, Heraklion/Crete.
