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Quantitative T2* imaging of iron overload in a non-dedicated center – Normal variation, repeatability and reader variation

Authors
  • Lidén, Mats1
  • Adrian, David2
  • Widell, Jonas2
  • Uggla, Bertil3
  • Thunberg, Per4
  • 1 Department of Radiology, Faculty of Medicine and Health, Örebro University, S-701 82, Sweden
  • 2 Department of Radiology, Örebro University Hospital, Region Örebro County, Sweden
  • 3 ity, Sweden
  • 4 Department of Medical Physics, Faculty of Medicine and Health, Örebro University, Sweden
Type
Published Article
Journal
European Journal of Radiology Open
Publisher
Elsevier
Publication Date
May 24, 2021
Volume
8
Identifiers
DOI: 10.1016/j.ejro.2021.100357
PMID: 34095355
PMCID: PMC8167145
Source
PubMed Central
Keywords
Disciplines
  • Article
License
Unknown

Abstract

Background Patients with transfusion dependent anemia are at risk of complications from iron overload. Quantitative T2* magnetic resonance imaging (MRI) is the best non-invasive method to assess iron deposition in the liver and heart and to guide chelation therapy. Purpose To investigate the image quality and inter-observer variations in T2* measurements of the myocardium and the liver, and to obtain the lower limit of cardiac and hepatic quantitative T2* values in patients without suspicion of iron overload. Material and methods Thirty-eight patients referred for cardiac MRI were prospectively included in the study. Three patients were referred with, and 35 without suspicion of iron overload. Quantitative T2* parametric maps were obtained on a 1.5 T MRI system in the cardiac short axis and liver axial view. Two readers independently assessed the image quality and the representative and the lowest T2* value in the myocardium and the liver. Results The normal range of representative T2* values in the myocardium and liver was 24−45 ms and 14−37 ms, respectively. None of the 35 participants (0 %, 95 % confidence interval 0–11 %) in the normal reference group demonstrated representative T2* values below previously reported lower limits in the myocardium (20 ms) or the liver (8 ms). Focal myocardial areas with T2* values near the lower normal range, 19−20 ms, were seen in two patients. The readers generally reported good image quality. Conclusion T2* imaging for assessing iron overload can be performed in a non-dedicated center with sufficient image quality.

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