Use of Magnetic Resonance Imaging to Monitor Iron Overload

Wood, John C.

doi:10.1016/j.hoc.2014.04.002

Cited by 94 publications

(85 citation statements)

References 68 publications

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“…Nevertheless, our findings provide meaningful information on the accuracies of PDFF and R2* measurements and the absence of confounding effects when a MECSE approach is used for fat and iron quantification in clinical practice. Although histological grading was obtained by consensus, biopsy as reference standard has large inter-observer and intra-observer variability [4,34]. In order to minimize the sampling bias, our MR measurements were estimated from the biopsied liver segment.…”

Section: Discussionmentioning

confidence: 99%

Accurate simultaneous quantification of liver steatosis and iron overload in diffuse liver diseases with MRI

et al. 2017

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Purpose: To evaluate the diagnostic performances of 3 Tesla multi-echo chemical shift-encoded gradient echo magnetic resonance (MECSE-MR) imaging to simultaneously quantify liver steatosis and iron overload in a wide spectrum of diffuse liver diseases having biopsy as reference standard. Methods: MECSE-MR-acquired images were used to calculate fat fraction and iron content in a single breathhold in 109 adult patients. Proton density fat fraction (PDFF) was prospectively estimated using complexbased data reconstruction with multipeak fat modeling. Water R2* was used to estimate iron content. Biopsy was obtained in all cases, grading liver steatosis, siderosis, inflammation, and fibrosis. Differences in PDFF and R2* values across histopathological grades were analyzed, and ROC curves analyses evaluated the MR diagnostic performance. Results: Calculated fat fraction measurements showed significant differences (p < 0.001) among steatosis grades, being unaffected by the presence of inflammation or fibrosis (p ‡ 0.05). A strong correlation was found between fat fraction and steatosis grade (R S = 0.718, p < 0.001). Iron deposits did not affect fat fraction quantitation (p ‡ 0.05), except in cases with severe iron overload (grade 4). A strong positive correlation was also observed between R2* measurements and iron grades (R S = 0.704, p < 0.001). Calculated R2* values were not different across grades of steatosis, inflammation, and fibrosis (p ‡ 0.05). Conclusion: A MECSE-MR sequence simultaneously quantifies liver steatosis and siderosis, regardless coexisting liver inflammation or fibrosis, with high accuracy in a wide spectrum of diffuse liver disorders. This sequence can be acquired within a single breath-hold and can be implemented in the routine MR evaluation of the liver.

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Section: Discussionmentioning

confidence: 99%

Accurate simultaneous quantification of liver steatosis and iron overload in diffuse liver diseases with MRI

et al. 2017

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“…However, increased serum ferritin is caused by several conditions, including inflammatory diseases, tissue damage, hematological malignancy, and immunodeficiency, and it does not accurately assess iron overload. 10,11 According to the clinical course shown in Fig. 4, the ferritin level did not improve following therapy for ATLL.…”

Section: Discussionmentioning

confidence: 93%

Welder’s pulmonary hemosiderosis associated with systemic iron overload following exacerbation of acute adult T-cell leukemia/lymphoma

Imoto

Shiraki

Furukawa

et al. 2017

J Clin Exp Hematopathol

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“…The liver signal intensity is modelled as a function of TE and fitted to either a monoexponential or bi-exponential decay model, calculating signal decay constants (T2 or T2*) or signal decay rates (R2 or R2*) [48]. Liver T2 and T2* (or R2, R2*) are closely related to LIC, and can be used in clinical practice as surrogates of LIC, provided that they are calculated with validated acquisition and analysis protocols [49].…”

Section: Mr Quantification Of Hepatic Iron Overloadmentioning

confidence: 99%

Liver MRI: From basic protocol to advanced techniques

Donato

França

Candelária

et al. 2017

European Journal of Radiology

112

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A B S T R A C TLiver MR is a well-established modality with multiparametric capabilities. However, to take advantage of its full capacity, it is mandatory to master the technique and optimize imaging protocols, apply advanced imaging concepts and understand the use of different contrast media. Physiologic artefacts although inherent to upper abdominal studies can be minimized using triggering techniques and new strategies for motion control. For standardization, the liver MR protocol should include motion-resistant T2-w sequences, in-op phase GRE T1 and T2-w fast spin echo sequences with fat suppression. Diffusion-weighted imaging (DWI) is mandatory, especially for detection of sub-centimetre metastases. Contrast-enhanced MR is the cornerstone of liver MR, especially for lesion characterization. Although extracellular agents are the most extensively used contrast agents, hepatobiliary contrast media can provide an extra-layer of functional diagnostic information adding to the diagnostic value of liver MR. The use of high field strength (3T) increases SNR but is more challenging especially concerning artefact control. Quantitative MR belongs to the new and evolving field of radiomics where the use of emerging biomarkers such as perfusion or DWI can derive new information regarding disease detection, prognostication and evaluation of tumour response. This information can overcome some of the limitations of current tests, especially when using vascular disruptive agents for oncologic treatment assessment. MR is, today, a robust, mature, multiparametric imaging modality where clinical applications have greatly expanded from morphology to advanced imaging. This new concept should be acknowledged by all those involved in producing high quality, high-end liver MR studies.

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Use of Magnetic Resonance Imaging to Monitor Iron Overload

Cited by 94 publications

References 68 publications

Accurate simultaneous quantification of liver steatosis and iron overload in diffuse liver diseases with MRI

Accurate simultaneous quantification of liver steatosis and iron overload in diffuse liver diseases with MRI

Welder’s pulmonary hemosiderosis associated with systemic iron overload following exacerbation of acute adult T-cell leukemia/lymphoma

Liver MRI: From basic protocol to advanced techniques

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