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Published in: Journal of Cardiovascular Magnetic Resonance 1/2008

Open Access 01-12-2008 | Research

Multi-center transferability of a breath-hold T2 technique for myocardial iron assessment

Authors: Taigang He, Paul Kirk, David N Firmin, Wynnie M Lam, Winnie CW Chu, Wing-Yan Au, Godfrey CF Chan, Ru San Tan, Ivy Ng, Selen Biceroglu, Yesim Aydinok, Mark A Fogel, Alan R Cohen, Dudley J Pennell

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2008

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Abstract

Background

Cardiac iron overload is the leading cause of death in thalassemia major and is usually assessed using myocardial T2* measurements. Recently a cardiovascular magnetic resonance (CMR) breath-hold T2 sequence has been developed as a possible alternative. This cardiac T2 technique has good interstudy reproducibility, but its transferability to different centres has not yet been investigated.

Methods and Results

The breath-hold black blood spin echo T2 sequence was installed and validated on 1.5T Siemens MR scanners at 4 different centres across the world. Using this sequence, 5–10 thalassemia patients from each centre were scanned twice locally within a week for local interstudy reproducibility (n = 34) and all were rescanned within one month at the standardization centre in London (intersite reproducibility). The local interstudy reproducibility (coefficient of variance) and mean difference were 4.4% and -0.06 ms. The intersite reproducibility and mean difference between scanners were 5.2% and -0.07 ms.

Conclusion

The breath-hold myocardial T2 technique is transferable between Siemens scanners with good intersite and local interstudy reproducibility. This technique may have value in the diagnosis and management of patients with iron overload conditions such as thalassemia.
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Literature
1.
go back to reference Tanner MA, Galanello R, Dessi C, Westwood MA, Smith GC, Nair SV, Anderson LJ, Walker JM, Pennell DJ: Myocardial iron loading in patients with thalassemia major on deferoxamine chelation. J Cardiovasc Magn Reson. 2006, 8: 543-547. 10.1080/10976640600698155.CrossRefPubMed Tanner MA, Galanello R, Dessi C, Westwood MA, Smith GC, Nair SV, Anderson LJ, Walker JM, Pennell DJ: Myocardial iron loading in patients with thalassemia major on deferoxamine chelation. J Cardiovasc Magn Reson. 2006, 8: 543-547. 10.1080/10976640600698155.CrossRefPubMed
2.
go back to reference Maceira AM, Prasad SK, Khan M, Pennell DJ: Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2006, 8: 417-526. 10.1080/10976640600572889.CrossRefPubMed Maceira AM, Prasad SK, Khan M, Pennell DJ: Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2006, 8: 417-526. 10.1080/10976640600572889.CrossRefPubMed
3.
go back to reference Olivieri NF, Nathan DG, MacMillan JH, Wayne AS, Liu PP, McGee A, Martin M, Koren G, Cohen AR: Survival in medically treated patients with homozygous beta-thalassemia. N Engl J Med. 1994, 331: 574-578. 10.1056/NEJM199409013310903.CrossRefPubMed Olivieri NF, Nathan DG, MacMillan JH, Wayne AS, Liu PP, McGee A, Martin M, Koren G, Cohen AR: Survival in medically treated patients with homozygous beta-thalassemia. N Engl J Med. 1994, 331: 574-578. 10.1056/NEJM199409013310903.CrossRefPubMed
4.
go back to reference Borgna-Pignatti C, Rugolotto S, De Stefano P, Zhao H, Cappellini MD, Del Vecchio GC, Romeo MA, Forni GL, Gamberini MR, Ghilardi R, Piga A, Cnaan A: Survival and complications in patients with thalassemia major treated with transfusion and deferoxamine. Haematologica. 2004, 89: 1187-1193.PubMed Borgna-Pignatti C, Rugolotto S, De Stefano P, Zhao H, Cappellini MD, Del Vecchio GC, Romeo MA, Forni GL, Gamberini MR, Ghilardi R, Piga A, Cnaan A: Survival and complications in patients with thalassemia major treated with transfusion and deferoxamine. Haematologica. 2004, 89: 1187-1193.PubMed
5.
go back to reference Tanner MA, Porter JB, Westwood MA, Nair SV, Anderson LJ, Walker JM, Pennell DJ: Myocardial T2* in patients with cardiac failure secondary to iron overload. Blood. 2005, 106 (Suppl): 40B-(Abstract 3838a) Tanner MA, Porter JB, Westwood MA, Nair SV, Anderson LJ, Walker JM, Pennell DJ: Myocardial T2* in patients with cardiac failure secondary to iron overload. Blood. 2005, 106 (Suppl): 40B-(Abstract 3838a)
6.
go back to reference Wood JC, Tyszka JM, Carson S, Nelson MD, Coates TD: Myocardial iron loading in transfusion- dependent thalassemia and sickle cell disease. Blood. 2004, 103: 1934-1936. 10.1182/blood-2003-06-1919.CrossRefPubMed Wood JC, Tyszka JM, Carson S, Nelson MD, Coates TD: Myocardial iron loading in transfusion- dependent thalassemia and sickle cell disease. Blood. 2004, 103: 1934-1936. 10.1182/blood-2003-06-1919.CrossRefPubMed
7.
go back to reference Anderson LJ, Wonke B, Prescott E, Holden S, Walker JM, Pennell DJ: Comparison of effects of oral deferiprone and subcutaneous desferrioxamine on myocardial iron levels and ventricular function in beta thalassemia. Lancet. 2002, 360: 516-520. 10.1016/S0140-6736(02)09740-4.CrossRefPubMed Anderson LJ, Wonke B, Prescott E, Holden S, Walker JM, Pennell DJ: Comparison of effects of oral deferiprone and subcutaneous desferrioxamine on myocardial iron levels and ventricular function in beta thalassemia. Lancet. 2002, 360: 516-520. 10.1016/S0140-6736(02)09740-4.CrossRefPubMed
8.
go back to reference Anderson LJ, Westwood MA, Holden S, Davis B, Prescott E, Wonke B, Porter JB, Walker JM, Pennell DJ: Myocardial iron clearance during reversal of siderotic cardiomyopathy with intravenous desferrioxamine: A prospective study using T2* cardiovascular magnetic resonance. Br J Haematol. 2004, 127: 348-355. 10.1111/j.1365-2141.2004.05202.x.CrossRefPubMed Anderson LJ, Westwood MA, Holden S, Davis B, Prescott E, Wonke B, Porter JB, Walker JM, Pennell DJ: Myocardial iron clearance during reversal of siderotic cardiomyopathy with intravenous desferrioxamine: A prospective study using T2* cardiovascular magnetic resonance. Br J Haematol. 2004, 127: 348-355. 10.1111/j.1365-2141.2004.05202.x.CrossRefPubMed
9.
go back to reference Pennell DJ, Berdoukas V, Karagiorga M, Ladis V, Piga A, Aessopos A, Gotsis ED, Tanner MA, Smith GC, Westwood MA, Wonke B, Galanello R: Randomized controlled trial of deferiprone or deferoxamine in beta-thalassemia major patients with asymptomatic myocardial siderosis. Blood. 2006, 107: 3738-3744. 10.1182/blood-2005-07-2948.CrossRefPubMed Pennell DJ, Berdoukas V, Karagiorga M, Ladis V, Piga A, Aessopos A, Gotsis ED, Tanner MA, Smith GC, Westwood MA, Wonke B, Galanello R: Randomized controlled trial of deferiprone or deferoxamine in beta-thalassemia major patients with asymptomatic myocardial siderosis. Blood. 2006, 107: 3738-3744. 10.1182/blood-2005-07-2948.CrossRefPubMed
10.
go back to reference Tanner MA, Galanello R, Dessi C, Smith GC, Westwood MA, Agus A, Roughton M, Assomull R, Nair SV, Walker JM, Pennell DJ: A randomized, placebo controlled, double blind trial of the effect of combined therapy with deferoxamine and deferiprone on myocardial iron in thalassemia major using cardiovascular magnetic resonance. Circulation. 2007, 115: 1876-1884. 10.1161/CIRCULATIONAHA.106.648790.CrossRefPubMed Tanner MA, Galanello R, Dessi C, Smith GC, Westwood MA, Agus A, Roughton M, Assomull R, Nair SV, Walker JM, Pennell DJ: A randomized, placebo controlled, double blind trial of the effect of combined therapy with deferoxamine and deferiprone on myocardial iron in thalassemia major using cardiovascular magnetic resonance. Circulation. 2007, 115: 1876-1884. 10.1161/CIRCULATIONAHA.106.648790.CrossRefPubMed
12.
go back to reference Westwood MA, Anderson LJ, Firmin DN, Gatehouse PD, Lorenz CH, Wonke B, Pennell DJ: Interscanner reproducibility of cardiovascular magnetic resonance T2* measurements of tissue iron in thalassemia. J Magn Reson Imaging. 2003, 18: 616-620. 10.1002/jmri.10396.CrossRefPubMed Westwood MA, Anderson LJ, Firmin DN, Gatehouse PD, Lorenz CH, Wonke B, Pennell DJ: Interscanner reproducibility of cardiovascular magnetic resonance T2* measurements of tissue iron in thalassemia. J Magn Reson Imaging. 2003, 18: 616-620. 10.1002/jmri.10396.CrossRefPubMed
13.
go back to reference Westwood MA, Firmin DN, Gildo M, Renzo G, Stathis G, Markissia K, Vasili B, Pennell DJ: Intercenter reproducibility of magnetic resonance T2* measurements of myocardial iron in thalassaemia. Int J Cardiovasc Imaging. 2005, 21: 531-538. 10.1007/s10554-005-0651-2.CrossRefPubMed Westwood MA, Firmin DN, Gildo M, Renzo G, Stathis G, Markissia K, Vasili B, Pennell DJ: Intercenter reproducibility of magnetic resonance T2* measurements of myocardial iron in thalassaemia. Int J Cardiovasc Imaging. 2005, 21: 531-538. 10.1007/s10554-005-0651-2.CrossRefPubMed
14.
go back to reference Tanner MA, He T, Westwood MA, Firmin DN, Pennell DJ, Thalassemia International Federation Heart T2* Investigators: Multi-center validation of the transferability of the magnetic resonance T2* technique for the quantification of tissue iron. Haematologica. 2006, 91: 1388-1391.PubMed Tanner MA, He T, Westwood MA, Firmin DN, Pennell DJ, Thalassemia International Federation Heart T2* Investigators: Multi-center validation of the transferability of the magnetic resonance T2* technique for the quantification of tissue iron. Haematologica. 2006, 91: 1388-1391.PubMed
15.
go back to reference Mavrogeni SI, Gotsis ED, Markussis V, Tsekos N, Politis C, Vretou E, Kermastinos D: T2 relaxation time study of iron overload in b-thalassemia. MAGMA. 1998, 6: 7-12. 10.1007/BF02662506.CrossRefPubMed Mavrogeni SI, Gotsis ED, Markussis V, Tsekos N, Politis C, Vretou E, Kermastinos D: T2 relaxation time study of iron overload in b-thalassemia. MAGMA. 1998, 6: 7-12. 10.1007/BF02662506.CrossRefPubMed
16.
go back to reference Papanikolaou N, Ghiatas A, Kattamis A, Ladis C, Kritikos N, Kattamis C: Non-invasive myocardial iron assessment in thalassaemic patients. T2 relaxometry and magnetization transfer ratio measurements. Acta Radiol. 2000, 41: 348-351. 10.1080/028418500127345442.CrossRefPubMed Papanikolaou N, Ghiatas A, Kattamis A, Ladis C, Kritikos N, Kattamis C: Non-invasive myocardial iron assessment in thalassaemic patients. T2 relaxometry and magnetization transfer ratio measurements. Acta Radiol. 2000, 41: 348-351. 10.1080/028418500127345442.CrossRefPubMed
17.
go back to reference Ghugre NR, Enriquez CM, Gonzalez I, Nelson MD, Coates TD, Wood JC: MRI detects myocardial iron in the human heart. Magn Reson Med. 2006, 56: 681-686. 10.1002/mrm.20981.PubMedCentralCrossRefPubMed Ghugre NR, Enriquez CM, Gonzalez I, Nelson MD, Coates TD, Wood JC: MRI detects myocardial iron in the human heart. Magn Reson Med. 2006, 56: 681-686. 10.1002/mrm.20981.PubMedCentralCrossRefPubMed
18.
go back to reference Wood JC, Otto-Duessel M, Aguilar M, Nick H, Nelson MD, Coates TD, Pollack H, Moats R: Cardiac iron determines cardiac T2*, T2, and T1 in the gerbil model of iron cardiomyopathy. Circulation. 2005, 112: 535-543. 10.1161/CIRCULATIONAHA.104.504415.PubMedCentralCrossRefPubMed Wood JC, Otto-Duessel M, Aguilar M, Nick H, Nelson MD, Coates TD, Pollack H, Moats R: Cardiac iron determines cardiac T2*, T2, and T1 in the gerbil model of iron cardiomyopathy. Circulation. 2005, 112: 535-543. 10.1161/CIRCULATIONAHA.104.504415.PubMedCentralCrossRefPubMed
19.
go back to reference He T, Gatehouse PD, Anderson LJ, Tanner M, Keegan J, Pennell DJ, Firmin DN: Development of a novel optimized breathhold technique for myocardial T2 measurement in thalassemia. J Magn Reson Imaging. 2006, 24: 580-585. 10.1002/jmri.20681.CrossRefPubMed He T, Gatehouse PD, Anderson LJ, Tanner M, Keegan J, Pennell DJ, Firmin DN: Development of a novel optimized breathhold technique for myocardial T2 measurement in thalassemia. J Magn Reson Imaging. 2006, 24: 580-585. 10.1002/jmri.20681.CrossRefPubMed
Metadata
Title
Multi-center transferability of a breath-hold T2 technique for myocardial iron assessment
Authors
Taigang He
Paul Kirk
David N Firmin
Wynnie M Lam
Winnie CW Chu
Wing-Yan Au
Godfrey CF Chan
Ru San Tan
Ivy Ng
Selen Biceroglu
Yesim Aydinok
Mark A Fogel
Alan R Cohen
Dudley J Pennell
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2008
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/1532-429X-10-11

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