Signal-intensity-ratio MRI accurately estimates hepatic iron load in hemodialysis patients

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Guy Rostoker1, Mireille Laroudie2, Raphaël Blanc3

  • 1Division of Nephrology and Dialysis (Service Néphrologie et de Dialyse), Ramsay-Générale de Santé, Hôpital Privé Claude Galien, Quincy sous Sénart, France.

Heliyon
|January 27, 2017
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) accurately measures iron overload in hemodialysis patients. This non-invasive method correlates well with liver biopsy, avoiding risks for patients with end-stage renal disease.

Area of Science:

  • Nephrology
  • Radiology
  • Hepatology

Background:

  • Iron overload is a growing concern in hemodialysis patients.
  • MRI protocols for iron estimation are validated in non-renal populations but not in dialysis patients.
  • Liver biopsy, the gold standard, poses ethical concerns due to invasiveness in frail ESRD patients.

Purpose of the Study:

  • To validate signal-intensity-ratio MRI (Rennes University algorithm) for assessing liver iron concentration in hemodialysis patients.
  • To compare MRI-based iron load estimation with histological classifications from liver biopsy.
  • To establish a reliable, non-invasive method for diagnosing iron overload in this vulnerable population.

Main Methods:

  • A pilot study compared MRI values with two histological classifications (Scheuer's and Deugnier and Turlin's) in 11 hemodialysis patients.
  • Patients underwent liver biopsy for medical reasons, allowing direct comparison.
  • The Rennes University algorithm was used for signal-intensity-ratio MRI analysis.

Main Results:

  • MRI and Scheuer's histological classification showed no significant difference in iron overload ranking (p=1).
  • Strong correlations were observed between MRI and Scheuer's classification (rho=0.866, p=0.0035).
  • High correlations were also found between MRI liver iron concentrations and Deugnier and Turlin's histological scoring (rho=0.841, p=0.0033).

Conclusions:

  • Signal-intensity-ratio MRI, using the Rennes University algorithm, accurately determines liver iron load in hemodialysis patients.
  • This non-invasive MRI approach provides a reliable alternative to liver biopsy for iron overload assessment.
  • The findings support the use of MRI for diagnosing and monitoring iron overload in hemodialysis patients.
Keywords:
Internal medicineMedical imagingMedicine

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