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01-08-2010 | Original Article

Comparison of whole liver and small region-of-interest measurements of MRI liver R2* in children with iron overload

Authors: M. Beth McCarville, Claudia M. Hillenbrand, Ralf B. Loeffler, Matthew P. Smeltzer, Ruitan Song, Chin-Shang Li, Jane S. Hankins

Published in: Pediatric Radiology | Issue 8/2010

Abstract

Background

Measurement of liver MRI T2* and R2* is emerging as a reliable alternative to liver biopsy for the quantitation of liver iron content. A systematic investigation of the influence of the region-of-interest size and placement has not been conducted.

Objective

To compare small and whole liver region-of-interest (ROI) MRI R2* values to each other and to biopsy liver iron content in patients with iron overload.

Materials and methods

Forty-one iron-overloaded patients, ages 7–35 years, underwent biopsy for liver iron content quantitation and MRI for liver R2* measurement within 30 days. Three reviewers independently used small and whole liver ROIs to measure R2*. Inter-reviewer agreement was assessed with the intra-class correlation coefficient (ICC). Associations between R2* and liver iron content were investigated using Spearman’s rank-order correlation and Monte Carlo estimated exact P values.

Results

Biopsy liver iron content and small and whole liver ROI R2* measurements were strongly associated for all reviewers (all P < 0.0001). Although inter-reviewer agreement was excellent for both ROI methods (ICC = 0.98–0.99), the small ROI technique more frequently led to inter-reviewer differences larger than 75 Hz, slightly higher R2* values, larger standard errors and greater range in values.

Conclusion

Small and whole liver ROI techniques are strongly associated with biopsy liver iron content. We found slightly greater inter-reviewer variability in R2* values using the small ROI technique. Because such variability could adversely impact patient management when R2* values are near a threshold of iron chelation therapy, we recommend using a whole liver ROI.

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Title: Comparison of whole liver and small region-of-interest measurements of MRI liver R2* in children with iron overload
Authors: M. Beth McCarville
Claudia M. Hillenbrand
Ralf B. Loeffler
Matthew P. Smeltzer
Ruitan Song
Chin-Shang Li
Jane S. Hankins
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: Pediatric Radiology / Issue 8/2010
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-010-1596-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of whole liver and small region-of-interest measurements of MRI liver R2* in children with iron overload

Abstract

Background

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

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