Emre Aslan1, Jack W Luo2, An Lesage1, Philippe Paquin1, Milena Cerny1,3, Anne Shu-Lei Chin1,4, Damien Olivié1,4, Guillaume Gilbert1,5, Denis Soulières6, An Tang7,8,9. 1. Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Montréal, Canada. 2. Department of Diagnostic Radiology, McGill University, Montréal, Canada. 3. Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada. 4. Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada. 5. MR Clinical Science, Philips Healthcare, Toronto, Canada. 6. Division of Hemato-Oncology, Department of Medicine, Université de Montréal, Montréal, Canada. 7. Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Montréal, Canada. an.tang@umontreal.ca. 8. Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada. an.tang@umontreal.ca. 9. Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada. an.tang@umontreal.ca.
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.
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.
Entities:
Keywords:
Hemochromatosis; Iron overload; MRI iron quantification; R2*; Transfusional hemosiderosis
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