Reassessing the value of MRI T2∗ in evaluation of hepatic and myocardial iron concentration: An institutional study

Abstract

Patients with chronic hemolytic anemia like thalassemia and sickle cell anemia need repeated blood transfusions which lead to iron overload and cellular damage especially in the heart and liver. Classically, serum ferritin and liver biopsy have been used to monitor patient response to chelation therapy. Magnetic resonance imaging (MRI) has been proved effective in detecting and quantifying iron in the heart and liver. Objective: To assess the accuracy of MRI T2∗ procedure in assessment of hepatic (LIC) and myocardial iron concentration (MIC). Methods In 70 cases of monthly transfused patients, hepatic and myocardial iron overload was measured by multibreath holds MRI T2∗ and compared to serum ferritin (a traditional marker of iron overload). Results: No significant correlation was observed between serum ferritin level and cardiac T2∗ MRI (p = 0.528, r = -0.077). However, a significant correlation was observed between serum ferritin and liver T2∗ MRI (p = 0.007, r = -0.318). Conclusion: Routine evaluation of liver and heart iron content using MRI T2∗ is suggested to better evaluate the hemosiderosis status in thalassemic and sickle cell patients.