Journal
MAGNETIC RESONANCE IN MEDICINE
Volume 71, Issue 6, Pages 2215-2223Publisher
WILEY-BLACKWELL
DOI: 10.1002/mrm.24854
Keywords
deferasirox; iron overload; -thalassemia; ESCALATOR; biopsy
Funding
- Novartis Pharma AG, Novartis Pharmaceuticals
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PurposeMagnetic resonance imaging (MRI)-based techniques for assessing liver iron concentration (LIC) have been limited by single scanner calibration against biopsy. Here, the calibration of spin-density projection-assisted (SDPA) R2-MRI (FerriScan (R)) in iron-overloaded -thalassemia patients treated with the iron chelator, deferasirox, for 12 months is validated. MethodsSDPA R2-MRI measurements and percutaneous needle liver biopsy samples were obtained from a subgroup of patients (n=233) from the ESCALATOR trial. Five different makes and models of scanner were used in the study. ResultsLIC, derived from mean of MRI- and biopsy-derived values, ranged from 0.7 to 50.1mg Fe/g dry weight. Mean fractional differences between SDPA R2-MRI- and biopsy-measured LIC were not significantly different from zero. They were also not significantly different from zero when categorized for each of the Ishak stages of fibrosis and grades of necroinflammation, for subjects aged 3 to <8 versus 8 years, or for each scanner model. Upper and lower 95% limits of agreement between SDPA R2-MRI and biopsy LIC measurements were 74 and -71%. ConclusionThe calibration curve appears independent of scanner type, patient age, stage of liver fibrosis, grade of necroinflammation, and use of deferasirox chelation therapy, confirming the clinical usefulness of SDPA R2-MRI for monitoring iron overload. Magn Reson Med 71:2215-2223, 2014. (c) 2013 Wiley Periodicals, Inc.
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