DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.
HASTE (Half fourier Single-shot Turbo spin-Echo) is a single-section T2-weighted sequence that acquires images in less than 1 second. Images are breathing independent and possess a variety of other features useful for imaging the abdomen. The design of this technique is described. Clinical studies of 38 consecutive patients were performed using this technique. HASTE images were considered good in 28 and fair in 10 patients, including five patients who could not suspend respiration. Definition of liver and bowel was particularly clear.
Purpose:To evaluate the usefulness of a time-efficient MRI method for the quantitative determination of tissue iron in the liver and heart of -thalassemic patients using spinspin relaxation rate, R2, measurements.
Materials and Methods:Images were obtained at 1.5 T from aqueous Gd-DTPA solutions (0.106 -8 mM) and from the liver and heart of 46 -thalassemic patients and 10 controls. The imaging sequence used was a respiratorytriggered 16-echo Carr-Purcell-Meiboom-Gill (CPMG) spinecho (SE) pulse sequence (TR ϭ 2000 msec, TE min ϭ 5 msec, echo spacing (ES) ϭ 5 msec, matrix ϭ 192 ϫ 256, slice thickness ϭ 10 mm). Liver iron concentration (LIC) measurements were obtained for 22 patients through biopsy specimens excised from the relevant liver segment. Biopsy specimens were also evaluated regarding iron grade and fibrosis. Serum ferritin (SF) measurements were obtained in all patients.Results: A statistically significant difference was found between patients and healthy controls in mean liver (P Ͻ 0.004) and myocardium (P Ͻ 0.004) R2 values. The R2 values correlated well with Gd DTPA concentration (r ϭ 0.996, P Ͻ 0.0001) and LIC (r ϭ 0.874, P Ͻ 0.0001). A less significant relationship (r ϭ 0.791, P Ͻ 0.0001) was found between LIC measurements and SF levels. R2 measurements appear to be significantly affected (P ϭ 0.04) by different degrees of hepatic fibrosis. The patients' liver R2 values did not correlate with myocardial R2 values (r ϭ 0.038, P Ͻ 0.21).
Conclusion:Tissue iron deposition in -thalassemic patients may be adequately quantified using R2 measurements obtained with a 16-echo MRI sequence with short ES (5 msec), even in patients with a relatively increased iron burden.
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