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Cardiovascular magnetic resonance T2* for tissue iron assessment in the heart
1Cardiovascular Science Research Centre, St George's, University of London, London, UK.
Insights
Accurate measurement of myocardial iron using cardiovascular magnetic resonance (CMR) T2* helps prevent deaths from iron-induced cardiomyopathy in thalassemia major patients. This technique guides chelation therapy, significantly reducing mortality.
Area of Science:
- Cardiology
- Medical Imaging
- Hematology
Background:
- Iron-induced cardiomyopathy was a leading cause of death in thalassemia major (TM) patients.
- Early detection and management of cardiac iron overload are crucial for preventing mortality.
- Cardiovascular magnetic resonance (CMR) T2* has become the gold standard for assessing myocardial iron.
Purpose of the Study:
- To review the history and development of CMR T2* for cardiac iron assessment.
- To describe T2* image acquisition and post-processing techniques.
- To discuss current challenges and emerging methods for improved iron characterization.
Main Methods:
- Review of the historical development of CMR T2* technology.
- Description of T2* imaging protocols and data analysis.
- Discussion of advancements in tissue iron quantification.
Main Results:
- CMR T2* is the preferred method for evaluating cardiac iron in TM.
- Clinical implementation of T2* in the UK has been associated with a 60% reduction in TM mortality.
- The article details the evolution and application of T2* in managing cardiac iron.
Conclusions:
- CMR T2* is essential for early detection and management of myocardial iron in TM.
- Accurate iron assessment guides chelation therapy, significantly improving patient outcomes.
- Ongoing research aims to further refine T2* techniques for even better iron characterization.
Abstract:
Until recently, even in Europe and the US, iron induced cardiomyopathy was the most common cause of death for patients with thalassemia major (TM). In order to prevent deaths from this potentially reversible condition, accurate measurement of myocardial iron is needed to detect iron early and guide chelation therapy. Cardiovascular magnetic resonance (CMR) T2* is the method of choice for the assessment of cardiac iron and in the UK, where it was first introduced clinically, 60% reductions in overall mortality for TM have been observed. The history of T2* development is described in this article. T2* image acquisition and post processing techniques are reviewed. Remaining challenges and emerging techniques to potentially improve characterization of tissue iron are also discussed.
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