Whole-body R2∗ mapping to quantify tissue iron in iron storage organs: reference values and a genotype

Kromrey, Marie‐Luise; Röhnert, Anne; Blum, Sophia; Winzer, Robert; Hoffman, RichardS.; Völzke, Henry; Kacprowski, Tim; Kühn, Jens‐Peter

doi:10.1016/j.crad.2021.05.016

Cited by 3 publications

(7 citation statements)

References 37 publications

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“…Median spleen R2* value in our control group was 19.3 s −1 (15.5–33.0 s −1 ), thus similar to 129 individuals in a healthy control group from a study by Schwenzer et al 36 (mean T2* of 43.9 ms, calculated mean R2* of 22.7 s −1 ) and slightly lower when compared with 38 263 individuals of the UK Biobank (IDEAL: 28.4 ± 13.7 s −1 ; GRE: 26.9 ± 11.6 s −1 ) 32 . When compared with a recent study in 301 volunteers without any HFE mutations, median spleen R2* values were also slightly higher compared with our control group (24.1 ± 13.8 s −1 ) 37 …”

Section: Resultscontrasting

confidence: 70%

“…CRP and IL-6 levels were higher in AI patients than in AI +IDA patients, which is why future studies should include CRP or IL-6 matched patients. Although the R2* relaxometry is established in measuring iron concentrations in different organs, 24,37 including liver, spleen, pancreas, and heart, R2* values in the spleen were not histologically verified by concomitant biopsies till now. although the conversion formulas for liver iron concentrations were used for spleen iron concentrations in several studies.…”

Section: Limitationsmentioning

confidence: 99%

“…32 When compared with a recent study in 301 volunteers without any HFE mutations, median spleen R2* values were also slightly higher compared with our control group (24.1 ± 13.8 s À1 ). 37 We further recruited a small cohort of 10 patients with TIO (seven men and three women): two patients with thalassemia, six patients with leukemia, one patient with lymphoma, and one patient with myelodysplastic syndrome. These patients received in median 10 erythrocyte concentrates within the last year, while only the two patients with thalassemia received chelation therapy.…”

Section: Patient Characteristicsmentioning

confidence: 99%

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Tissue iron distribution in patients with anemia of inflammation: Results of a pilot study

et al. 2023

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Anemia of inflammation (AI) is frequently present in subjects with inflammatory disorders, primarily caused by inflammation-driven iron retention in macrophages. So far, only limited data on qualitative and quantitative estimates of tissue iron retention in AI patients exist. We performed a prospective cohort study analyzing splenic, hepatic, pancreatic, and cardiac iron content with MRI-based R2*-relaxometry in AI patients, including subjects with concomitant true iron deficiency (AI+IDA) hospitalized between 05/2020-01/2022. Control groups were individuals without inflammation. Spleen R2* values in AI patients with ferritin ≤200 μg/L (AI+IDA) were comparable with those found in controls. In AI patients with ferritin >200 μg/L, spleen (47.6 s À1 vs. 19.3 s À1 , p < .001) and pancreatic R2* values (32.5 s À1 vs. 24.9 s À1 , p = .011) were significantly higher compared with controls, while liver and heart R2*-values did not differ. Higher spleen R2* values were associated with higher ferritin, hepcidin, CRP, and IL-6 concentrations. Spleen R2* values normalized in AI patients after recovery (23.6 s À1 vs. 47.6 s À1 , p = .008), while no changes were found in patients with baseline AI+IDA. This is the first study investigating tissue iron distribution in patients with inflammatory anemia and AI with concomitant true iron deficiency. The results support the findings in animal models demonstrating iron retention in macrophages, which are primarily accumulating in the spleen under inflammatory conditions. MRI-related iron measurement may help to better characterize actual iron needs and to define better biomarker thresholds in the diagnosis of true ID in patients with AI. It may qualify as a useful diagnostic method to estimate the need for iron supplementation and to guide therapy.

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Section: Resultscontrasting

confidence: 70%

Section: Limitationsmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

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Tissue iron distribution in patients with anemia of inflammation: Results of a pilot study

et al. 2023

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“…The effects were less detectable when ultrasound was used to diagnose fatty liver disease. The MR methodology is based on that described by Kühn et al [ 80 , 86 , 87 ].…”

Section: Resultsmentioning

confidence: 99%

“…Kromrey et al [ 87 ] investigated the importance of the human hemochromatosis protein (HFE) genotype for iron storage in different organs. In 483 study participants without evidence of iron storage disease, R2* levels were determined in organs that can store iron, such as the liver, spleen, pancreas, heart, bone, and lung parenchyma.…”

Section: Resultsmentioning

confidence: 99%

SHIP-MR and Radiology: 12 Years of Whole-Body Magnetic Resonance Imaging in a Single Center

et al. 2021

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The Study of Health in Pomerania (SHIP), a population-based study from a rural state in northeastern Germany with a relatively poor life expectancy, supplemented its comprehensive examination program in 2008 with whole-body MR imaging at 1.5 T (SHIP-MR). We reviewed more than 100 publications that used the SHIP-MR data and analyzed which sequences already produced fruitful scientific outputs and which manuscripts have been referenced frequently. Upon reviewing the publications about imaging sequences, those that used T1-weighted structured imaging of the brain and a gradient-echo sequence for R2* mapping obtained the highest scientific output; regarding specific body parts examined, most scientific publications focused on MR sequences involving the brain and the (upper) abdomen. We conclude that population-based MR imaging in cohort studies should define more precise goals when allocating imaging time. In addition, quality control measures might include recording the number and impact of published work, preferably on a bi-annual basis and starting 2 years after initiation of the study. Structured teaching courses may enhance the desired output in areas that appear underrepresented.

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Tissue Iron Distribution in Anemic Patients with End-Stage Kidney Disease: Results of a Pilot Study

Lanser,

Plaikner,

Fauser

et al. 2024

JCM

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Background/Objectives: Anemia is a frequent multifactorial co-morbidity in end-stage kidney disease (ESKD) associated with morbidity and poor QoL. Apart from insufficient erythropoietin formation, iron deficiency (ID) contributes to anemia development. Identifying patients in need of iron supplementation with current ID definitions is difficult since no good biomarker is available to detect actual iron needs. Therefore, new diagnostic tools to guide therapy are needed. Methods: We performed a prospective cohort study analyzing tissue iron content with MRI-based R2*-relaxometry in 20 anemic ESKD patients and linked it with iron biomarkers in comparison to 20 otherwise healthy individuals. Results: ESKD patients had significantly higher liver (90.1 s−1 vs. 36.1 s−1, p < 0.001) and spleen R2* values (119.8 s−1 vs. 19.3 s−1, p < 0.001) compared to otherwise healthy individuals, while their pancreas and heart R2* values did not significantly differ. Out of the 20 ESKD patients, 17 had elevated spleen and 12 had elevated liver R2* values. KDIGO guidelines (focusing on serum iron parameters) would recommend iron supplementation in seven patients with elevated spleen and four patients with elevated liver R2* values. Conclusions: These findings highlight that liver and especially spleen iron concentrations are significantly higher in ESKD patients compared to controls. Tissue iron overload diverged from classical iron parameters suggesting need of iron supplementation. Measurement of MRI-guided tissue iron distribution might help guide treatment of anemic ESKD patients.

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Whole-body R2∗ mapping to quantify tissue iron in iron storage organs: reference values and a genotype

Cited by 3 publications

References 37 publications

Tissue iron distribution in patients with anemia of inflammation: Results of a pilot study

Tissue iron distribution in patients with anemia of inflammation: Results of a pilot study

SHIP-MR and Radiology: 12 Years of Whole-Body Magnetic Resonance Imaging in a Single Center

Tissue Iron Distribution in Anemic Patients with End-Stage Kidney Disease: Results of a Pilot Study

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