The worth of diffusion-weighted imaging for quantifying liver iron concentration in transfusion-dependent thalassemia...

BackgroundMagnetic resonance imaging (MRI) is currently the primary method for evaluating liver iron concentration (LIC); however, most techniques necessitate intricate data post-processing. Consequently, the development of simple quantitative methods is highly desirable.PurposeTo investigate the value of diffusion-weighted imaging (DWI) for quantifying LIC in patients with transfusion-dependent thalassemia (TDT).Material and MethodsData were collected on patients with TDT, including conventional MRI iron quantification sequences such as FerriScan R2, T2*, and DWI data. The liver's apparent diffusion coefficient (ADC) and T2* values were measured, and these measurements were compared to the LIC reports obtained from MRI-R2/FerriScan, which are U.S. Food and Drug Administration certified, to evaluate the utility of ADC values in quantitatively assessing LIC.ResultsAmong the 58 patients with TDT, the linear regression analysis indicated R² values in the range of approximately 0.4765-0.6022 for ADC values and LIC, with non-linear regression R² in the range of 0.6263-0.6479. The T2* model demonstrated excellent diagnostic accuracy for extremely severe liver iron overload with an area under the receiver operating characteristic curve (AUC) of 0.996, whereas the ADC model exhibited a similarly high AUC in the range of 0.891-0.941.ConclusionIn patients with known hepatic iron overload due to TDT, ADC values show a correlation with liver iron content and have the potential to serve as a supplementary method for quantitative measurement of liver iron by T2*/R2*.