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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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Submitted December 15, 2008
Accepted February 26, 2009
R2* magnetic resonance imaging of the liver in patients with iron overload
Jane S. Hankins*, M. Beth McCarville, Ralf B. Loeffler, Matthew P. Smeltzer, Mihaela Onciu, Fredric A. Hoffer, Chin-Shang Li, Winfred C. Wang, Russell E. Ware, and Claudia M. Hillenbrand
Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, United States
Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN, United States
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, United States
Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, United States
* Corresponding author; email: jane.hankins{at}stjude.org.
R2*-MRI can quantify hepatic iron content (HIC) by non-invasive 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 (32),  -thalassemia major (6), and bone marrow failure (5)] were analyzed: median age 14 years, median transfusion duration 15 months, average (± 1SD) serum ferritin 2718 ± 1994 ng/mL, and average HIC 10.9 ± 6.8 mg Fe/g dry weight liver. Regions of interest were drawn and analyzed by three 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<.0001). This high correlation confirms prior reports, calibrates R2*-MRI measurements, and suggests its clinical utility for predicting HIC using R2*-MRI. This study is registered at www.clinicaltrials.gov under #NCT00675038
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