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Comparative Sequence Assessment of Optimised T2 and T2* Sequences for Quantification of Iron in Transfused Dependent Paediatric Sickle Cell Anaemia (SCA) Patients

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World Congress on Medical Physics and Biomedical Engineering 2018

Part of the book series: IFMBE Proceedings ((IFMBE,volume 68/1))

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Abstract

Despite the fact that Sickle Cell Anaemia (SCA) patients undergo blood transfusion to reduce the risk of some complications associated with the disease, however, regular blood transfusion inevitably causes iron overload. In Sudan, the levels of iron in blood-transfused patients are regularly monitored using the serum ferritin, which is widely known to be an unreliable marker for body iron balance. The use of magnetic resonance imaging techniques such as theT2 and T2* sequences have demonstrated promising results in estimating iron concentration in transfused dependent patients Wood (Blood 106:1460–1465, 2005, [1]). There is however little data on the literature that systematically compared T2 and T2* in sickle cell anaemia (SCA) Wood (Am J Hematol 90:806–810, 2015, [2]). The aims of this work are to investigate two optimised T2 and T2* sequences, determine their viability for the quantification of iron in transfused dependent SCA and compare them to the standard serum ferritin method. The two optimised sequences were subsequently investigated on livers of 10 volunteers and 25 SCA paediatric patients using a 1.5T Philips scanner located at Al Ateeba Hospital in Khartoum State-Capital of Sudan. Ethical approval for the study was obtained from the National Ministry of Health-Health Research Council-Sudan. Linear correlation was found between T2* and serum ferritin (R2 = 0.949, P < 0.001), T2 and serum (R2 = 0.946, P < 0.001) and T2 and T2* measurements (R2 = 0.921, P = 0.789). The results demonstrate that both of the optimised T2 and T2* sequences could provide reliable measurements in the quantification of range of iron concentrations on transfused dependent paediatric SCA patients.

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References

  1. Wood JC, Enriquez C, Ghugre NJ, Tyzka N, Carson S, Nelson MD, and Coates TD. MRI R2 and R2* mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood 2005:106;1460–1465.

    Google Scholar 

  2. Wood JC, Pressel S, Rogers ZR, Odame I, Kwiatkowski JL, Lee MT, Owen WC, Cohen AR, Pierre ST, Heeney MM, Schultz WH, Davis BR, Ware RE. Liver iron concentration measurements by MRI in chronically transfused children with Sickle Cell Anemia: Baseline Results from the TWiTCH Trail. Am J Hematol. 2015;90:806–810.

    Google Scholar 

  3. Gordeuk VR, Bacon BR, Brittenham GM. Iron Overload: causes and consequences. Annu Rev Nutr 1987;7:485–508.

    Google Scholar 

  4. McLaren GD, Muir WA, Kellermeyer RW. Iron overload disorders: natural history, pathogenesis, diagnosis, and therapy. Crit Rev Clin Lab Sci 1983;19:205–66.

    Google Scholar 

  5. He T, Gatehouse PD, Anderson LJ, Tanner M, Keegan J, Pennell DJ, Firmin DN. Development of a novel optimized breath hold technique for myocardial T2 measurement in thalassemia. J Magn Reson Imaging 2006;24:580–585.

    Google Scholar 

  6. Brittenham G, Cohen A, McLaren C, et al. Hepatic iron stores in plasma ferritin concentration in patients with sickle cell anemia and thalassemia major. Am. J. Hematol 1993;42:81–85.

    Google Scholar 

  7. Prieto J, Barry M, Sherlock S. Serum ferritin in patients with iron overload and with acute and chronic liver diseases. Gastroenterology 1975;68:525–533.

    Google Scholar 

  8. Kolnagou A, Eracleous E, Economides Ch, Kontoghiorghes GJ. Low serum ferritin levels are misleading for detecting excess cardiac iron loading and increase of risk of cardiomyopathy in thalassemia patients. The importance of cardiac iron overload monitoring using magnetic resonance imaging T2 and T2*.Hemoglobin. 2006;30:219–227.

    Google Scholar 

  9. Nielsen P, Gunther U, Durken M, Fischer R, Dullmann J. Serum ferritin iron in iron overload and liver damage: correlation to body iron stores and diagnostic relevance. J Lab Clin Med 2000;135(5):413–418.

    Google Scholar 

  10. Wood JC and Ghurge N. Magnetic resonance imaging assessment of excess iron in thalassemia, sickle cell disease and other overload diseases. Hemoglobin. 2008;32(1–2):85–96.

    Google Scholar 

  11. Correlation between serum ferritin levels and liver iron concentration determined by MR imaging: impact of hematologic disease and inflammation. MagnReson Imaging. 2007 Feb;25(2):228–31.

    Google Scholar 

  12. Modell B, Khan M, Darlison M, Westwood MA, Ingram D, Pennell DJ. Improved survival of thalassemia major in the UK and relation of T2* cardiovascular magnetic resonance. J. Cardiovascular Magnetic Resonance 2008;10:42.

    Google Scholar 

  13. Isreal J, Unger E, Buetow K, Brown T, Blumberg B, London WT. Correlation between liver iron content and magnetic resonance imaging. MagnReson Imaging 1989;7:629–634.

    Google Scholar 

  14. Wood JC, Duessel MO, Auguilar M, Nick H, Nelson MD, Coates TD, Pollack H and Moates R. Cardiac Iron Determines Cardiac T2*, T2 and T1 in the Gerbil Model of Iron Cardiomyopathy. Circulation 2005;112:535:543.

    Google Scholar 

  15. Willinek WA, Gieseke J, Kukuk GM, Nelles M, Konig R, Morakkabati-Spitz N, Traber F, Thomas D, Kuhl CK, Schild HH. Dual-source parallel radiofrequency excitation body MR imaging compared with standard MR imaging at 3.0 T: initial clinical experience Radiology. 2010;256(3):966–975. https://doi.org/10.1148/radiol.10092127.

  16. Ghurge N.R, Enriquez C.M, Coates T.D, Nelson M.D, Wood J. C. Improved R2* Measurements in Myocardial Iron Overload. J MagnReson Imaging. 2006; 23:9–16.

    Google Scholar 

  17. Positano V, Salani B, Pepe A, Santarelli MF, De Marchi D, Ramazzotti A, et al. ImprovedT2*assessment in liver iron overload by magnetic resonance imaging. MagnReson Imaging.2009;27:188–97.

    Google Scholar 

  18. He T, Gatehouse PD, Anderson LJ, Tanner M, Keegan J, Pennell DJ, Firmin DN. Development of a novel optimised breath hold technique for myocardial T2 measurement in thalassemia. J Magn Reson Imaging 2006;24:580–585.

    Google Scholar 

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Correspondence to Azza Ahmed .

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Ahmed, A., Baldo, A., Margani, H., Fatah, A., Idris, I., Salih, I. (2019). Comparative Sequence Assessment of Optimised T2 and T2* Sequences for Quantification of Iron in Transfused Dependent Paediatric Sickle Cell Anaemia (SCA) Patients. In: Lhotska, L., Sukupova, L., Lacković, I., Ibbott, G.S. (eds) World Congress on Medical Physics and Biomedical Engineering 2018. IFMBE Proceedings, vol 68/1. Springer, Singapore. https://doi.org/10.1007/978-981-10-9035-6_11

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  • DOI: https://doi.org/10.1007/978-981-10-9035-6_11

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