Hepatic iron overload in thalassemic patients: Proposal and validation of an MRI method of assessment

Bonetti, Matteo; Castriota-Scanderbeg, Alessandro; Criconia, G M; Mazza, Patrizio; Sacco, Michele; Amurri, B; Masi, C

doi:10.1007/bf01356827

Cited by 33 publications

(15 citation statements)

References 17 publications

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“…Nine studies of at least 10 thalassemic patients that evaluated the accuracy of measurement of LIC by MRI, and included a quantitative measurement of MRI signal and a detailed description of the patient population were selected (Table 2). 4,22,24,[26][27][28][29][30][31][32] Strong linear correlations (R 2 =approximate-ly 1.0) were demonstrated in four studies. 4,[27][28][29] The best result was obtained with the R2 methodology which resulted in a curvilinear relationship between R2 and LIC by biopsy over the entire clinically relevant range of LICs.…”

Section: Measures Of Body Iron Load Requiring Initiation Of Iron Chelmentioning

confidence: 79%

“…Nine studies with more than 10 patients that analyzed the accuracy of SF were selected (Table 1). 4,9,[18][19][20][21][22][23][24] Strong linear correlation (R 2 =approximately 1.0), enabling precise quantitative estimation of body iron content, was demonstrated in one study 20 but only in patients without a histological picture of liver hepatitis. There was good linear correlation (R 2 >0.5) in four out of the remaining studies 17,18,23,25 but in one of them, only in patients with lower iron burden.…”

Section: Measures Of Body Iron Load Requiring Initiation Of Iron Chelmentioning

confidence: 99%

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Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders

Angelucci¹,

Barosi²,

Camaschella³

et al. 2008

Haematologica

182

156

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New measures of iron accumulation in liver and heart (superconducting quantum inference device and magnetic resonance imaging), and oral iron chelators (deferiprone and deferasirox) are available for managing iron overload in thalassemia major. To assure appropriate use of these new health technologies, the Italian Society of Hematology appointed a panel of experts to produce clinical practiceguidelines for the management of iron overload in thalassemia major and related disorders. The analytical hierarchy process, a technique for multicriteria decision analysis, was applied to relevant key questions in order to identify the alternative strategies, generate explicit criteria for their evaluation, and check how well the alternatives fulfilled the criteria. The result of a comprehensive systematic review of articles released from 1990 to 2007 was used as a source of scientific evidence to compare the decisional options pairwise, and select the final recommendation. Every step in the model was developed from questionnaires and group discussion. The resulting recommendations advise about which examination to carry out in order to plan iron chelation therapy, when to start iron chelation, which iron chelator to choose in regularly transfused patients, how to monitor iron chelation therapy, and when and how to switch standard therapy.

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Section: Measures Of Body Iron Load Requiring Initiation Of Iron Chelmentioning

confidence: 79%

Section: Measures Of Body Iron Load Requiring Initiation Of Iron Chelmentioning

confidence: 99%

Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders

Angelucci¹,

Barosi²,

Camaschella³

et al. 2008

Haematologica

182

156

View full text Add to dashboard Cite

show abstract

“…MRI has also been used to detect iron overload in patients with hemochromatosis 11,13 and transfusion-dependent thalassemia. 31 The limitations of MRI are that it underestimates iron levels in organs if the levels are extremely high and that the signal intensity varies in patients with advanced cirrhosis. 32,33 Neither of these problems was encountered in our patients.…”

Section: Discussionmentioning

confidence: 99%

Genetic and Clinical Features of Hemoglobin H Disease in Chinese Patients

et al. 2000

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“…140,141 The most widely used method of this kind was developed at the University of Renne, France, by Gandon et al 142 The signal intensity of the iron-overloaded liver is compared with that of a nonoverloaded reference tissue, usually the paraspinal muscle, by taking the ratio of the two. 140,141 The most widely used method of this kind was developed at the University of Renne, France, by Gandon et al 142 The signal intensity of the iron-overloaded liver is compared with that of a nonoverloaded reference tissue, usually the paraspinal muscle, by taking the ratio of the two.…”

Section: Pastmentioning

confidence: 99%

Fat and Iron Quantification in the Liver

Yokoo¹,

Browning²

2014

Topics in Magnetic Resonance Imaging

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Liver fat, iron, and combined overload are common manifestations of diffuse liver disease and may cause lipotoxicity and iron toxicity via oxidative hepatocellular injury, leading to progressive fibrosis, cirrhosis, and eventually, liver failure. Intracellular fat and iron cause characteristic changes in the tissue magnetic properties in predictable dose-dependent manners. Using dedicated magnetic resonance pulse sequences and postprocessing algorithms, fat and iron can be objectively quantified on a continuous scale. In this article, we will describe the basic physical principles of magnetic resonance fat and iron quantification and review the imaging techniques of the "past, present, and future." Standardized radiological metrics of fat and iron are introduced for numerical reporting of overload severity, which can be used toward objective diagnosis, grading, and longitudinal disease monitoring. These noninvasive imaging techniques serve an alternative or complimentary role to invasive liver biopsy. Commercial solutions are increasingly available, and liver fat and iron quantitative imaging is now within reach for routine clinical use and may soon become standard of care.

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Hepatic iron overload in thalassemic patients: Proposal and validation of an MRI method of assessment

Abstract: Both the subjective and the quantitative MRI methods proposed here are clinically valuable, with the former being adequate for a gross, the latter for an accurate estimation of tissue iron overload.

Cited by 33 publications

References 17 publications

Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders

Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders

Genetic and Clinical Features of Hemoglobin H Disease in Chinese Patients

Fat and Iron Quantification in the Liver

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