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 Blood, 14 May 2009, Vol. 113, No. 20, pp. 4853-4855.
Prepublished online as a Blood First Edition Paper on March 4, 2009; DOI 10.1182/blood-2008-12-191643.

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CLINICAL TRIALS AND OBSERVATIONS

Brief Report

R2* magnetic resonance imaging of the liver in patients with iron overload

Jane S. Hankins1, M. Beth McCarville2, Ralf B. Loeffler2, Matthew P. Smeltzer3, Mihaela Onciu4, Fredric A. Hoffer2, Chin-Shang Li3, Winfred C. Wang1, Russell E. Ware1, and Claudia M. Hillenbrand2

Departments of 1 Hematology, 2 Radiological Sciences, 3 Biostatistics, and 4 Pathology, St Jude Children's Research Hospital, Memphis, TN

R2* magnetic resonance imaging (R2*-MRI) can quantify hepatic iron content (HIC) by noninvasive means but is not fully investigated. Patients with iron overload completed 1.5T R2*-MRI examination and liver biopsy within 30 days. Forty-three patients (sickle cell anemia, n = 32; β-thalassemia major, n = 6; and bone marrow failure, n = 5) were analyzed: median age, 14 years, median transfusion duration, 15 months, average (±SD) serum ferritin 2718 plus or minus 1994 ng/mL, and average HIC 10.9 plus or minus 6.8 mg Fe/g dry weight liver. Regions of interest were drawn and analyzed by 3 independent reviewers with excellent agreement of their measurements (intraclass correlation coefficient = 0.98). Ferritin and R2*-MRI were weakly but significantly associated (range of correlation coefficients among the 3 reviewers, 0.41-0.48; all P < .01). R2*-MRI was strongly associated with HIC for all 3 reviewers (correlation coefficients, 0.96-0.98; all P < .001). This high correlation confirms prior reports, calibrates R2*-MRI measurements, and suggests its clinical utility for predicting HIC using R2*-MRI. This study was registered at www.clinicaltrials.gov as #NCT00675038 [ClinicalTrials.gov] .


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