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Prepublished online as a Blood First Edition Paper on August 29, 2002; DOI 10.1182/blood-2002-06-1723.
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Blood, 1 January 2003, Vol. 101, No. 1, pp. 15-19
PERSPECTIVE
Noninvasive measurement of iron: report of an NIDDK
workshop
Gary M. Brittenham and
David G. Badman
From Columbia University College of Physicians and
Surgeons, New York, NY; and the Division of Kidney, Urologic and
Hematologic Diseases/National Institute of Diabetes and Digestive and
Kidney Diseases, National Institutes of Health, Bethesda, MD.
An international workshop on the noninvasive measurement of iron
was conducted by the National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK) on April 17, 2001, to assess the current state
of the science and to identify areas needing further investigation. The
workshop concluded that a clear clinical need is evident for quantitative, noninvasive, safe, accurate, and readily available means
of measuring body storage iron to improve the diagnosis and management
of patients with iron overload from such disorders as hereditary
hemochromatosis, thalassemia major, sickle cell disease, aplastic
anemia, and myelodysplasia, among others. Magnetic resonance imaging
(MRI) potentially provides the best available technique for examining
the 3-dimensional distribution of excess iron in the body, but further
research is needed to develop means of making measurements
quantitative. Biomagnetic susceptometry provides the only noninvasive
method to measure tissue iron stores that has been calibrated,
validated, and used in clinical studies, but the complexity, cost, and
technical demands of the liquid-helium-cooled superconducting
instruments required at present have restricted clinical access to the
method. The workshop identified basic and clinical research
opportunities for deepening our understanding of the physical
properties of iron and iron toxicity, for further investigation of MRI
as a method for quantitative determinations of tissue iron, especially
in liver, heart and brain, and for development of improved methods and
more widely available instrumentation for biomagnetic susceptometry.
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