Real-World Experience Measurement of Liver Iron Concentration by R2 Vs. R2 Star MRI in Hemoglobinopathies

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2020 Oct 2

PMID 33003498

Citations 2

Authors

Riad Abou Zahr

Barbara E U Burkhardt

Lubaina Ehsan

Amanda Potersnak

Gerald Greil

Jeanne Dillenbeck

Zora Rogers

Tarique Hussain

Affiliations

Soon will be listed here.

Abstract

Background: Non-invasive determination of liver iron concentration (LIC) is a valuable tool that guides iron chelation therapy in transfusion-dependent patients. Multiple methods have been utilized to measure LIC by MRI. The purpose of this study was to compare free breathing R2* (1/T2*) to whole-liver Ferriscan R2 method for estimation of LIC in a pediatric and young adult population who predominantly have hemoglobinopathies.

Methods: Clinical liver and cardiac MRI scans from April 2016 to May 2018 on a Phillips 1.5 T scanner were reviewed. Free breathing T2 and T2* weighted images were acquired on each patient. For T2, multi-slice spin echo sequences were obtained. For T2*, a single mid-liver slice fast gradient echo was performed starting at 0.6 ms with 1.2 ms increments with signal averaging. R2 measurements were performed by Ferriscan analysis. R2* measurements were performed by quantitative T2* map analysis.

Results: 107 patients underwent liver scans with the following diagnoses: 76 sickle cell anemia, 20 Thalassemia, 9 malignancies and 2 Blackfan Diamond anemia. Mean age was 12.5 ± 4.5 years. Average scan time for R2 sequences was 10 min, while R2* sequence time was 20 s. R2* estimation of LIC correlated closely with R2 with a correlation coefficient of 0.94. Agreement was strongest for LIC < 15 mg Fe/g dry weight. Overall bias from Bland-Altman plot was 0.66 with a standard deviation of 2.8 and 95% limits of agreement -4.8 to 6.1.

Conclusion: LIC estimation by R2* correlates well with R2-Ferriscan in the pediatric age group. Due to the very short scan time of R2*, it allows imaging without sedation or anesthesia. Cardiac involvement was uncommon in this cohort.

Citing Articles

Blood transfusion and iron overload in patients with Sickle Cell Disease (SCD): Personal experience and a short update of diabetes mellitus occurrence.

Soliman A, De Sanctis V, Yassin M, Alshurafa A, Ata F, Nashwan A Acta Biomed. 2022; 93(4):e2022291.

PMID: 36043959 PMC: 9534241. DOI: 10.23750/abm.v93i4.13330.

Iron Overload in Patients With Heavily Transfused Sickle Cell Disease-Correlation of Serum Ferritin With Cardiac T2 MRI (CMRTools), Liver T2 MRI, and R2-MRI (Ferriscan®).

Alkindi S, Panjwani V, Al-Rahbi S, Al-Saidi K, Pathare A Front Med (Lausanne). 2021; 8:731102.

PMID: 34760898 PMC: 8573209. DOI: 10.3389/fmed.2021.731102.

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