Aims and objectives
The quantification and monitoring of body iron burden play a pivotal role in the clinical management of patients affected by inherited hemoglobin disorders,
hereditary hemochromatosis and sickle cell disease.
The total amount of iron deposited in the organs well correlates with serum ferritin levels (expressed in ng/mL); however,
serum ferritin lacks of specificity,
since it may be affected by other factors such as fever or inflammation.
Liver iron content (LIC),
expressed as mg Fe/g dry tissue,
is considered a reliable biomarker of the...
Methods and materials
This retrospective observational study was performed on 15 thalassemic patients undergoing MRI examinations under chelation therapy and about fifty FerriScanTM-T2 and T2* MRI examinations were performed and compared.
Exams were done with a 1.5T General Electric Hdx scanner using an eight-element cardiac/torso coil.
Breath-hold T2*-MRI measurements were performed and the whole liver was scanned employing a multi-echo gradient echo sequence.
T2-MRI measurements were performed with a multislice single spin-echo pulse sequence according to the FerriScanTM protocol and the images acquired were sent via a secure...
The time evolution of liver iron content was analyzed and clinically discussed case-by-case for the patients which had at least one point outside the ±1 SD interval in the Bland-Altman plot.
Although all T2* methods are in good agreement with the FerriScanTM results,
the best accordance with LICdw deriving from FerriScanTM is reached by the measurement obtained from Quanta Hematology; the corresponding Bland-Altman analysis has mean of 0.1 mg/g and a standard deviation (SD) of 1.5 mg/g.
The good agreement observed between the T2* method and the goldstandard (FerriScanTM T2),
makes suitable in our opinion the use of different commercial software for liver iron concentration monitoring in clinical routine.
In our series of patients and measurements we observed two cases where FerriScanTM appeared to overestimate the LIC,
particularly when the LIC had higher values.
In these cases we don’t have a biopsy to allow direct quantification of LIC but we consider that FerriScanTM could have overestimated the LIC because the decrease over...
Wood et al., “MRI R2 and R2-star mapping accurately estimates hepatic iron concentration” (2005)
StPierre et al., “Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance” (2005)
Meloni et al., “The use of appropriate calibration curves systematic differences in liver R2star values measured using different software packages” (2013)
Fernandes et al., “Heart and liver T2 assessment for iron overload using different software programs” (2011)
Wood et al., “Disparities Between Two Common MRI Metrics of Liver Iron Concentration...