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MRI-based R2* mapping in patients with suspected or known iron overload

  • Hepatobiliary
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Abstract

Purpose

R2* relaxometry is a quantitative method for assessment of iron overload. The purpose is to analyze the cross-sectional relationships between R2* in organs across patients with primary and secondary iron overload. Secondary analyses were conducted to analyze R2* according to treatment regimen.

Methods

This is a retrospective, cross-sectional, institutional review board-approved study of eighty-one adult patients with known or suspected iron overload. R2* was measured by segmenting the liver, spleen, bone marrow, pancreas, renal cortex, renal medulla, and myocardium using breath-hold multi-echo gradient-recalled echo imaging at 1.5 T. Phlebotomy, transfusion, and chelation therapy were documented. Analyses included correlation, Kruskal–Wallis, and post hoc Dunn tests. p < 0.01 was considered significant.

Results

Correlations between liver R2* and that of the spleen, bone marrow, pancreas, and heart were respectively 0.49, 0.33, 0.27, and 0.34. R2* differed between patients with primary and secondary overload in the liver (p < 0.001), spleen (p < 0.001), bone marrow (p < 0.01), renal cortex (p < 0.001), and renal medulla (p < 0.001). Liver, spleen, and bone marrow R2* were higher in thalassemia than in hereditary hemochromatosis (all p < 0.01). Renal cortex R2* was higher in sickle cell disease than in hereditary hemochromatosis (p < 0.001) and in thalassemia (p < 0.001). Overall, there was a trend toward lower liver R2* in patients assigned to phlebotomy and higher liver R2* in patients assigned to transfusion and chelation therapy.

Conclusion

R2* relaxometry revealed differences in degree or distribution of iron overload between organs, underlying etiologies, and treatment.

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Abbreviations

HFE:

High iron Fe

HH:

Hereditary hemochromatosis

MRI:

Magnetic resonance imaging

ROI:

Region of interest

SCD:

Sickle cell disease

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Funding

Funding for this project was supported by Grants from the Canadian Institutes of Health Research (CIHR)-Institute of Nutrition, Metabolism and Diabetes (INMD) (CIHR-INMD #273738 and #301520), from the Fonds de recherche du Québec en Santé (FRQS) and Fondation de l'association des radiologistes du Québec (FARQ) Clinical Research Scholarship – Junior 1 and 2 Salary Awards (FRQS-FARQ #26993 and #34939), and from the Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM) to An Tang.

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Authors and Affiliations

  1. Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Montréal, Canada

    Emre Aslan, An Lesage, Philippe Paquin, Milena Cerny, Anne Shu-Lei Chin, Damien Olivié, Guillaume Gilbert & An Tang

  2. Department of Diagnostic Radiology, McGill University, Montréal, Canada

    Jack W. Luo

  3. Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada

    Milena Cerny & An Tang

  4. MR Clinical Science, Philips Healthcare, Toronto, Canada

    Guillaume Gilbert

  5. Division of Hemato-Oncology, Department of Medicine, Université de Montréal, Montréal, Canada

    Denis Soulières

  6. Department of Radiology, Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada

    Anne Shu-Lei Chin, Damien Olivié & An Tang

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  1. Emre Aslan
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  2. Jack W. Luo
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  10. An Tang
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Correspondence to An Tang.

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Aslan, E., Luo, J.W., Lesage, A. et al. MRI-based R2* mapping in patients with suspected or known iron overload. Abdom Radiol 46, 2505–2515 (2021). https://doi.org/10.1007/s00261-020-02912-w

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  • DOI: https://doi.org/10.1007/s00261-020-02912-w

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