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Published in: Insights into Imaging 2/2012

Open Access 01-04-2012 | Review

Quantification of iron concentration in the liver by MRI

Authors: José María Alústiza Echeverría, Agustín Castiella, José Ignacio Emparanza

Published in: Insights into Imaging | Issue 2/2012

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Abstract

Objective

Measurement of liver iron concentration is a key parameter for the management of patients with primary and secondary haemochromatosis. Magnetic resonance imaging (MRI) has already demonstrated high accuracy to quantify liver iron content. To be able to improve the current management of patients that are found to have iron overload, we need a reproducible, standardised method that is, or can easily be made, widely available.

Methods

This article discusses the different MRI techniques and models to quantify liver iron concentration that are currently available and envisaged for the near future from a realistic perspective.

Results

T2 relaxometry methods are more accurate than signal intensity ratio (SIR) methods and they are reproducible but are not yet standardised or widely available. SIR methods, on the other hand, are very specific for all levels of iron overload and, what is more, they are also reproducible, standardised and already widely available.

Conclusions

For these reasons, today, both methods remain necessary while progress is made towards universal standardisation of the relaxometry technique.
Literature
1.
go back to reference Brittenham GM, Badman DG (2003) Non invasive measurement of iron: report of an NIDDK workshop. Blood 101:15–19PubMedCrossRef Brittenham GM, Badman DG (2003) Non invasive measurement of iron: report of an NIDDK workshop. Blood 101:15–19PubMedCrossRef
2.
go back to reference Pietrangelo A, Deugnier Y, Dooley J et al (2010) EASL clinical practice guidelines for HFE haemochromatosis. European Association for the Study of the Liver. J Hepatol 53:3–22CrossRef Pietrangelo A, Deugnier Y, Dooley J et al (2010) EASL clinical practice guidelines for HFE haemochromatosis. European Association for the Study of the Liver. J Hepatol 53:3–22CrossRef
3.
go back to reference Allen KJ, Gurrin LC, Constantine CC et al (2008) Iron-overload-related disease in HFE hereditary haemochromatosis. N Engl J Med 358:221–230PubMedCrossRef Allen KJ, Gurrin LC, Constantine CC et al (2008) Iron-overload-related disease in HFE hereditary haemochromatosis. N Engl J Med 358:221–230PubMedCrossRef
4.
go back to reference Villeneuve JP, Bilofdeau M, Lepage R et al (1996) Variability in hepatic iron concentration measurement from needle-biopsy specimens. J Hepatol 25:172–177PubMedCrossRef Villeneuve JP, Bilofdeau M, Lepage R et al (1996) Variability in hepatic iron concentration measurement from needle-biopsy specimens. J Hepatol 25:172–177PubMedCrossRef
5.
go back to reference Ambu R, Crisponi G, Sciot R et al (1995) Uneven hepatic iron and phosphorus distribution in beta-thalassemia. J Hepatol 23:544–549PubMedCrossRef Ambu R, Crisponi G, Sciot R et al (1995) Uneven hepatic iron and phosphorus distribution in beta-thalassemia. J Hepatol 23:544–549PubMedCrossRef
6.
go back to reference Crisponi G, Ambu R, Cristiani F et al (2000) Does iron concentration in a liver needle biopsy accurately reflect hepatic iron burden in beta-thalassemia? Clin Chem 46:1185–1188PubMed Crisponi G, Ambu R, Cristiani F et al (2000) Does iron concentration in a liver needle biopsy accurately reflect hepatic iron burden in beta-thalassemia? Clin Chem 46:1185–1188PubMed
7.
go back to reference Emond MJ, Bronner MP, Carlson TH et al (1999) Quantitative study of the variability of hepatic iron concentrations. Clin Chem 45:340–346PubMed Emond MJ, Bronner MP, Carlson TH et al (1999) Quantitative study of the variability of hepatic iron concentrations. Clin Chem 45:340–346PubMed
8.
go back to reference St Pierre TG, Clark PR, Chua-anusorn W et al (2005) Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood 105:855–861PubMedCrossRef St Pierre TG, Clark PR, Chua-anusorn W et al (2005) Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood 105:855–861PubMedCrossRef
9.
go back to reference Alexopoulou E, Stripeli F, Baras P et al (2006) R2 relaxometry with MRI for the quantification of tissue iron overload in beta-thalassemic patients. J Magn Reson Imaging 23:163–170PubMedCrossRef Alexopoulou E, Stripeli F, Baras P et al (2006) R2 relaxometry with MRI for the quantification of tissue iron overload in beta-thalassemic patients. J Magn Reson Imaging 23:163–170PubMedCrossRef
10.
go back to reference Anderson LJ, Holden S, Davis B et al (2001) Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J 22:2171–2179PubMedCrossRef Anderson LJ, Holden S, Davis B et al (2001) Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J 22:2171–2179PubMedCrossRef
11.
go back to reference Wood JC, Enriquez C, Ghugre N et al (2005) MRI R2 and R2* mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood 106:1460–1465PubMedPubMedCentralCrossRef Wood JC, Enriquez C, Ghugre N et al (2005) MRI R2 and R2* mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood 106:1460–1465PubMedPubMedCentralCrossRef
12.
go back to reference Westwood MA, Anderson LJ, Firmin DN et al (2003) A single breath-hold multiecho T2* cardiovascular magnetic resonance technique for diagnosis of myocardial iron overload. J Magn Reson Imaging 18:33–39PubMedCrossRef Westwood MA, Anderson LJ, Firmin DN et al (2003) A single breath-hold multiecho T2* cardiovascular magnetic resonance technique for diagnosis of myocardial iron overload. J Magn Reson Imaging 18:33–39PubMedCrossRef
13.
14.
go back to reference St Pierre TG, Clark PR, Chua-Anusorn W (2004) Single spin-echo proton transverse relaxometry of iron loaded-liver. NMR Biomed 17:446–448PubMedCrossRef St Pierre TG, Clark PR, Chua-Anusorn W (2004) Single spin-echo proton transverse relaxometry of iron loaded-liver. NMR Biomed 17:446–448PubMedCrossRef
16.
17.
go back to reference Papakonstantinou O, Kostaridou S, Man's T (1999) Quantification of liver iron overload by T2 quantitative magnetic resonance imaging in thalassemia: impact of chronic hepatitis C on measurements. J Pediatr Hematol Oncol 21:142–148PubMedCrossRef Papakonstantinou O, Kostaridou S, Man's T (1999) Quantification of liver iron overload by T2 quantitative magnetic resonance imaging in thalassemia: impact of chronic hepatitis C on measurements. J Pediatr Hematol Oncol 21:142–148PubMedCrossRef
18.
go back to reference Christoforidis A, Perifanis V, Spanos G et al (2009) MRI assessment of liver iron content in thalassamic patients with three different protocols: comparisons and correlations. Eur J Haematol 82:388–392PubMedCrossRef Christoforidis A, Perifanis V, Spanos G et al (2009) MRI assessment of liver iron content in thalassamic patients with three different protocols: comparisons and correlations. Eur J Haematol 82:388–392PubMedCrossRef
19.
go back to reference Positano V, Salani B, Pepe A et al (2009) Improved T2* assessment in liver iron overload by magnetic resonance imaging. Magn Reson Imaging 27:188–197PubMedCrossRef Positano V, Salani B, Pepe A et al (2009) Improved T2* assessment in liver iron overload by magnetic resonance imaging. Magn Reson Imaging 27:188–197PubMedCrossRef
22.
23.
go back to reference Meloni A, Ramazzotti A, Positano V et al (2009) Evaluation of a web-based network for reproducible T2* MRI assessment of iron overload in thalassemia. Int J Med Inform 78:503–512PubMedCrossRef Meloni A, Ramazzotti A, Positano V et al (2009) Evaluation of a web-based network for reproducible T2* MRI assessment of iron overload in thalassemia. Int J Med Inform 78:503–512PubMedCrossRef
24.
go back to reference Gandon Y, Olivié D, Guyader D et al (2004) Non-invasive assessment of hepatic iron stores by MRI. Lancet 363:357–362PubMedCrossRef Gandon Y, Olivié D, Guyader D et al (2004) Non-invasive assessment of hepatic iron stores by MRI. Lancet 363:357–362PubMedCrossRef
25.
go back to reference Alústiza JM, Artetxe J, Castiella A et al (2004) MR quantification of hepatic iron concentration. Radiology 230:479–484PubMedCrossRef Alústiza JM, Artetxe J, Castiella A et al (2004) MR quantification of hepatic iron concentration. Radiology 230:479–484PubMedCrossRef
26.
go back to reference Ernst O, Sergent G, Bonvarlet P et al (1997) Hepatic iron overload: diagnosis and quantification with MR imaging. AJR Am J Roentgenol 168:1205–1208PubMedCrossRef Ernst O, Sergent G, Bonvarlet P et al (1997) Hepatic iron overload: diagnosis and quantification with MR imaging. AJR Am J Roentgenol 168:1205–1208PubMedCrossRef
27.
go back to reference Ernst O, Rose C, Sergent G et al (1999) Hepatic iron overload: quantification with MR imaging at 1.5 T. AJR Am J Roentgenol 172:1141–1142PubMedCrossRef Ernst O, Rose C, Sergent G et al (1999) Hepatic iron overload: quantification with MR imaging at 1.5 T. AJR Am J Roentgenol 172:1141–1142PubMedCrossRef
28.
go back to reference Bonkovsky HL, Rubin RB, Cable EE et al (1999) Hepatic iron concentration: non-invasive estimation by means of MR imaging techniques. Radiology 212:227–232PubMedCrossRef Bonkovsky HL, Rubin RB, Cable EE et al (1999) Hepatic iron concentration: non-invasive estimation by means of MR imaging techniques. Radiology 212:227–232PubMedCrossRef
30.
go back to reference Rose C, Vandevenne P, Bourgeois E et al (2006) Liver iron content assessment by routine and simple magnetic resonance imaging procedure in highly transfused patients. Eur J Haematol 77:145–149PubMedCrossRef Rose C, Vandevenne P, Bourgeois E et al (2006) Liver iron content assessment by routine and simple magnetic resonance imaging procedure in highly transfused patients. Eur J Haematol 77:145–149PubMedCrossRef
31.
go back to reference Castiella A, Alústiza JM, Emparanza JI et al (2011) Liver iron concentration quantification by MRI. Are recommended protocols accurate enough for clinical practice? Eur Radiol 21:137–141PubMedCrossRef Castiella A, Alústiza JM, Emparanza JI et al (2011) Liver iron concentration quantification by MRI. Are recommended protocols accurate enough for clinical practice? Eur Radiol 21:137–141PubMedCrossRef
Metadata
Title
Quantification of iron concentration in the liver by MRI
Authors
José María Alústiza Echeverría
Agustín Castiella
José Ignacio Emparanza
Publication date
01-04-2012
Publisher
Springer Berlin Heidelberg
Published in
Insights into Imaging / Issue 2/2012
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1007/s13244-011-0132-1

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