Pustika Amalia Wahidiyat1, Felix Liauw2, Damayanti Sekarsari3, Siti Ayu Putriasih2, Vasili Berdoukas4, Dudley J Pennell5. 1. a Pediatric Hematology-Oncology Division, Department of Child Health, Faculty of Medicine , Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital , Jakarta , Indonesia. 2. b Department of Child Health, Faculty of Medicine , Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital , Jakarta , Indonesia. 3. c Department of Radiology, Faculty of Medicine , Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital , Jakarta , Indonesia. 4. d University of Southern California, Keck School of Medicine Children's Hospital , Los Angeles , USA. 5. e CMR Unit , Royal Brompton Hospital , London , United Kingdom.
Abstract
OBJECTIVES: Recent advancements have promoted the use of T2* magnetic resonance imaging (MRI) in the non-invasive detection of iron overload in various organs for thalassemia major patients. This study aims to determine the iron load in the heart and liver of patients with thalassemia major using T2* MRI and to evaluate its correlation with serum ferritin level and iron chelation therapy. METHODS: This cross-sectional study included 162 subjects diagnosed with thalassemia major, who were classified into acceptable, mild, moderate, or severe cardiac and hepatic iron overload following their T2* MRI results, respectively, and these were correlated to their serum ferritin levels and iron chelation therapy. RESULTS: The study found that 85.2% of the subjects had normal cardiac iron stores. In contrast, 70.4% of the subjects had severe liver iron overload. A significant but weak correlation (r = -0.28) was found between cardiac T2* MRI and serum ferritin, and a slightly more significant correlation (r = 0.37) was found between liver iron concentration (LIC) and serum ferritin. DISCUSSION: The findings of this study are consistent with several other studies, which show that patients generally manifest with liver iron overload prior to cardiac iron overload. Moreover, iron accumulation demonstrated by T2* MRI results also show a significant correlation to serum ferritin levels. CONCLUSION: This is the first study of its kind conducted in Indonesia, which supports the fact that T2* MRI is undoubtedly valuable in the early detection of cardiac and hepatic iron overload in thalassemia major patients.
OBJECTIVES: Recent advancements have promoted the use of T2* magnetic resonance imaging (MRI) in the non-invasive detection of iron overload in various organs for thalassemia major patients. This study aims to determine the iron load in the heart and liver of patients with thalassemia major using T2* MRI and to evaluate its correlation with serum ferritin level and iron chelation therapy. METHODS: This cross-sectional study included 162 subjects diagnosed with thalassemia major, who were classified into acceptable, mild, moderate, or severe cardiac and hepatic iron overload following their T2* MRI results, respectively, and these were correlated to their serum ferritin levels and iron chelation therapy. RESULTS: The study found that 85.2% of the subjects had normal cardiac iron stores. In contrast, 70.4% of the subjects had severe liver iron overload. A significant but weak correlation (r = -0.28) was found between cardiac T2* MRI and serum ferritin, and a slightly more significant correlation (r = 0.37) was found between liver iron concentration (LIC) and serum ferritin. DISCUSSION: The findings of this study are consistent with several other studies, which show that patients generally manifest with liver iron overload prior to cardiac iron overload. Moreover, iron accumulation demonstrated by T2* MRI results also show a significant correlation to serum ferritin levels. CONCLUSION: This is the first study of its kind conducted in Indonesia, which supports the fact that T2* MRI is undoubtedly valuable in the early detection of cardiac and hepatic iron overload in thalassemia major patients.
Entities:
Keywords:
T2* MRI; cardiac iron; hepatic iron; thalassemia major
Authors: Pandji Irani Fianza; Anita Rahmawati; Sri Hudaya Widihastha; Shofura Afifah; Mohammad Ghozali; Andre Indrajaya; Dilli Marayuzan Akbar Pratama; Dimmy Prasetya; Teddy Arnold Sihite; Mas Rizky A A Syamsunarno; Djatnika Setiabudi; Suthat Fucharoen; Ramdan Panigoro Journal: Anemia Date: 2021-04-15