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[MRI for assessment of iron overload in patients with hematologic disease]
Chao Xiao1, Shucheng Gu1, Yanjun Xu1
1Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Objective:
Compare the characteristics of magnetic resonance imaging（MRI）liver T2*, cardiac T2* and serum ferritin on the assessment of iron overload.
Methods:
A total of sixty-nine patients from November 2011 to June 2014 were enrolled in this study. Their cardiac and liver iron concentration levels were measured through MRI examination, with other clinical data were collected to perform statistical analysis.
Results:
The correlation between liver T2* and adjusted serum ferritin（ASF） was statistically significant（P=0.003）. However, no significant correlation was found between cardiac T2* and liver T2*, ASF, respectively. According to the statistical analysis of the 69 cases, it is found that the number of iron overload cases diagnosed by liver T2* was 62 and 20 cases were severe iron overload （32.26%）; the number of iron overload cases diagnosed by ASF was 47 and 14 cases were severe iron overload（29.79%）, while the number of iron overload cases diagnosed by cardiac T2* was only 25 and no severe iron overload cases.
Conclusion:
Since SF was affected by other factors, it cannot reflect the level of iron overload in human body objectively. Now, liver T2* has become the gold standard for assessment of iron overload because of its good reliability and repeatability. However, cardiac T2* cannot correctly be used as assessment for iron overload, and it is only a method of evaluating the level of cardiac iron deposition.
Insights
Liver T2* magnetic resonance imaging (MRI) is the gold standard for assessing iron overload, showing better reliability than serum ferritin or cardiac T2*. Cardiac T2* is only suitable for evaluating cardiac iron deposition.
Area of Science:
- Radiology and Imaging
- Hematology
- Cardiology
Background:
- Iron overload requires accurate assessment for effective management.
- Magnetic resonance imaging (MRI) offers non-invasive methods for evaluating iron levels.
- Serum ferritin and cardiac T2* are commonly used but may have limitations.
Purpose of the Study:
- To compare the effectiveness of liver T2* MRI, cardiac T2* MRI, and serum ferritin in assessing iron overload.
- To determine the most reliable method for diagnosing and quantifying iron overload.
Main Methods:
- A study involving sixty-nine patients was conducted between November 2011 and June 2014.
- Liver and cardiac iron concentrations were measured using MRI.
- Clinical data and serum ferritin levels were collected for statistical analysis.
Main Results:
- Liver T2* showed a significant correlation with adjusted serum ferritin (P=0.003).
- Liver T2* identified more cases of iron overload (62) and severe iron overload (20) compared to serum ferritin (47 and 14, respectively).
- Cardiac T2* identified only 25 cases of iron overload with no severe cases, indicating limited utility for overall iron overload assessment.
Conclusions:
- Serum ferritin levels can be influenced by various factors, limiting their objectivity in reflecting iron overload.
- Liver T2* MRI is established as the gold standard for iron overload assessment due to its reliability and repeatability.
- Cardiac T2* MRI is primarily useful for assessing cardiac iron deposition, not overall body iron overload.
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