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Iron overload MRI

Hassan M Moukhadder, Joseph E Roumi, Rayan Bou-Fakhredin, Ali T Taher
The incidence of hepatocellular carcinoma (HCC) in patients with thalassemia is increasing, the two well recognized HCC risk factors in thalassemia being iron overload and chronic hepatitis C. The carcinogenicity of iron is related to its induction of oxidative damage, whereas chronic hepatitis leads to necroinflammation that can accelerate progression to HCC. We hereby report the case of a non transfused, hepatitis C-negative, β-thalassemia intermedia (β-TI) patient from our practice who had evidence of significant iron overload, suggesting the importance of increased iron burden as a HCC risk factor in this patient population...
March 1, 2018: Hemoglobin
Huimin Lin, Hongjiang Wei, Naying He, Caixia Fu, Shu Cheng, Jun Shen, Baisong Wang, Xu Yan, Chunlei Liu, Fuhua Yan
PURPOSES: To evaluate the feasibility of simultaneous quantification of liver iron concentration (LIC) and fat fraction (FF) using water-fat separation and quantitative susceptibility mapping (QSM). METHODS: Forty-five patients suspected of liver iron overload (LIO) were included. A volumetric interpolated breath-hold examination sequence for QSM and FF, a fat-saturated gradient echo sequence for R2 * , a spin echo sequence for LIC measurements and MRS analyses for FF (FF-MRS) were performed...
February 22, 2018: European Radiology
Suraj D Serai, Andrew T Trout, Robert J Fleck, Charles T Quinn, Jonathan R Dillman
PURPOSE: The purpose of this study is determine if both liver T2* and cardiac T2* can be measured on a single breath-hold acquisition. MATERIALS AND METHODS: For this IRB-approved retrospective study, 137 patients with dedicated Cardiac MRI and Liver MRI examinations obtained sequentially on 1.5T scanners and on the same day were included for analysis. Both the cardiac and liver MRI examinations utilized GRE sequences for quantification of tissue iron. Specifically, T2* was measured using an 8-echo, multi-echo gradient echo single breath-hold sequence...
February 22, 2018: Abdominal Radiology
Mohammad Soleiman Soltanpour, Kambiz Davari
Objectives: Organ-specific hemosiderosis and iron overload complications are more serious and more frequent in some patients with beta thalassemia major (BTM) compared with others. We investigated whether coinheritance of HFE H63D or C282Y gene mutations in patients with BTM contributes to the phenotypic variation of iron overload complications and assessed the correlation of cardiac and hepatic hemosiderosis with plasma ferritin levels. Methods: We studied 60 patients with BTM with a mean age of 17...
January 2018: Oman Medical Journal
Juliano Lara Fernandes
MRI is a key tool in the current management of patients with thalassemia. Given its capability of assessing iron overload in different organs noninvasively and without contrast, it has significant advantages over other metrics, including serum ferritin. Liver iron concentration can be measured either with relaxometry methods T2*/T2 or signal intensity ratio techniques. Myocardial iron can be assessed in the same examination through T2* imaging. In this review, we focus on showing how MRI evaluates iron in both organs and the clinical applications as well as practical approaches to using this tool by clinicians taking care of patients with thalassemia...
April 2018: Hematology/oncology Clinics of North America
Yesim Aydinok
Introduction of MRI techniques for identifying and monitoring tissue iron overload and the current understanding of iron homeostasis in transfusion-dependent (TDT) and non-transfusion-dependent thalassemia have allowed for a more robust administration of iron chelation therapies. The development of safe and efficient oral iron chelators and the insights gained from large-scale prospective studies using these agents have improved iron overload management. A significant reduction in iron toxicity-induced morbidity and mortality and improvements in quality of life were observed in TDT...
April 2018: Hematology/oncology Clinics of North America
P Nemtsas, M Arnaoutoglou, V Perifanis, E Koutsouraki, G Spanos, N Arnaoutoglou, P Chalkia, D Pantelidou, A Orologas
The thalassemias are the most common single gene disorder in the world. Nowadays, the average life expectancy of patients in developed countries has increased significantly, while, there was an increase of complications. We aimed to investigate peripheral neuropathy and myopathy in this patient group using a neurophysiological study. We performed nerve conduction studies and electromyography of upper and lower extremities on 36 beta-thalassemia major (β-thal) patients. The electrophysiological findings were correlated with demographic data and laboratory parameters of the disease...
February 9, 2018: Annals of Hematology
Mozhgan Parsaee, Nehzat Akiash, Azita Azarkeivan, Zahra Alizadeh Sani, Ahmad Amin, Mahboubeh Pazoki, Niloufar Samiei, Mohammad Ali Jalili, Mohammad Hassan Adel, Nahid Rezaian
BACKGROUND: Heart failure is the biggest cause of mortality and morbidity in people with thalassemia, and iron deposition in cardiac tissue impairs cardiovascular function. Therefore, early detection of cardiac involvement is important to improve the prognosis in these individuals. METHOD: Two- and three-dimensional echocardiography was performed to evaluate left ventricular ejection fraction (LVEF), left ventricular volumes and diameters, and global longitudinal strain (GLS) in 130 individuals with β-thalassemia using the speckle tracking method...
February 4, 2018: Echocardiography
Dong-Mei Zou, Dong-Dong Rong, Hong Zhao, Li Su, Wan-Ling Sun
RATIONALE: This report describes seroconversion of hepatitis B surface antigen (HBsAg) in a patient with marked iron overload caused by chronic hepatitis B (CHB) after receiving iron chelation therapy and discusses the role of iron chelation therapy in CHB. PATIENT CONCERNS: Increased serum ferritin level for 2 months. DIAGNOSIS: Secondary iron overload and CHB. INTERVENTION: To relieve iron load of the body, the patient underwent regular phlebotomy therapy and deferoxamine (DFO) therapy...
December 2017: Medicine (Baltimore)
G Grolez, M Kyheng, R Lopes, C Moreau, K Timmerman, F Auger, G Kuchcinski, A Duhamel, P Jissendi-Tchofo, P Besson, C Laloux, M Petrault, J C Devedjian, Thierry Pérez, Pierre François Pradat, L Defebvre, R Bordet, V Danel-Brunaud, D Devos
For patients with amyotrophic lateral sclerosis (ALS), the primary therapeutic goal is to minimize morbidity. Non-invasive ventilation improves survival. We aim to assess whether Magnetic Resonance Imaging (MRI) of the cervical spinal cord predicts the progression of respiratory disorders in ALS. Brain and spinal MRI was repeatedly performed in the SOD1G86R mouse model, in 40 patients and in healthy controls. Atrophy, iron overload, white matter diffusivity and neuronal loss were assessed. In Superoxide Dismutase-1 (SOD1) mice, iron accumulation appeared in the cervical spinal cord at symptom onset but disappeared with disease progression (after the onset of atrophy)...
January 29, 2018: Scientific Reports
Paolo Ricchi, Antonella Meloni, Anna Spasiano, Silvia Costantini, Alessia Pepe, Patrizia Cinque, Aldo Filosa
This study analysed the impact of liver steatosis (LS) on the parameters of iron overload in 110 patients with non-transfusion dependent thalassaemia (NTDT). LS was diagnosed by ultrasound. Liver iron concentration (LIC) measurements were available for 64 patients who underwent a magnetic resonance imaging (MRI) scan. LS was frequent (35·5%) and was significantly more prevalent in males than in females (49·0% vs. 24·6%, P = 0·008). Patients with LS had significant higher levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), ALT/AST ratio and ferritin than those without, but LIC values were comparable...
January 24, 2018: British Journal of Haematology
Sophie Mavrogeni, Genovefa Kolovou, Boris Bigalke, Angelos Rigopoulos, Michel Noutsias, Stamatis Adamopoulos
In iron overload diseases (thalassemia, sickle cell, and myelodysplastic syndrome), iron is deposited in all internal organs, leading to functional abnormalities. Hematopoietic stem cell transplantation (HSCT) is the only treatment offering a potential cure in these diseases. Our aim was to describe the experience in the field and the role of magnetic resonance imaging in the evaluation of iron overload before and after HSCT. Magnetic resonance imaging (MRI), using T2*, is the most commonly used tool to diagnose myocardial-liver iron overload and guide tailored treatment...
January 23, 2018: Heart Failure Reviews
B Henninger
This Editorial comment refers to the article: Non-invasive measurement of liver iron concentration using 3-Tesla magnetic resonance imaging: validation against biopsy. D'Assignies G, et al. Eur Radiol Nov 2017. KEY POINTS: • MRI is a widely accepted reliable tool to determine liver iron concentration. • MRI cannot measure iron directly, it needs calibration. • Calibration curves for 3.0T are rare in the literature. • The study by d'Assignies et al. provides valuable information on this topic...
January 9, 2018: European Radiology
Hunter C Davis, Pradeep Ramesh, Aadyot Bhatnagar, Audrey Lee-Gosselin, John F Barry, David R Glenn, Ronald L Walsworth, Mikhail G Shapiro
Magnetic resonance imaging (MRI) is a widely used biomedical imaging modality that derives much of its contrast from microscale magnetic field patterns in tissues. However, the connection between these patterns and the appearance of macroscale MR images has not been the subject of direct experimental study due to a lack of methods to map microscopic fields in biological samples. Here, we optically probe magnetic fields in mammalian cells and tissues with submicron resolution and nanotesla sensitivity using nitrogen-vacancy diamond magnetometry, and combine these measurements with simulations of nuclear spin precession to predict the corresponding MRI contrast...
January 9, 2018: Nature Communications
Paula Fernanda Silva Fonseca, Rodolfo Delfini Cançado, Flavio Augusto Naoum, Carla Luana Dinardo, Guilherme Henrique Hencklain Fonseca, Sandra Fatima Menosi Gualandro, José Eduardo Krieger, Alexandre Costa Pereira, Pierre Brissot, Paulo Caleb Junior Lima Santos
BACKGROUND: Hereditary hemochromatosis (HH) encompasses a group of autosomal recessive disorders mainly characterized by enhanced intestinal absorption of iron and its accumulation in parenchymal organs. HH diagnosis is based on iron biochemical and magnetic resonance imaging (MRI) assessment, and genetic testing. Questionnaires, such as SF-36 (short form health survey), have been increasingly used to assess the impact of diseases on the patient's quality of life (QL). In addition, different genotypes are identified as results of genetic tests in patients with suspected primary iron overload...
January 5, 2018: BMC Medical Genetics
Isara Phiwchai, Wiphawee Yuensook, Natsaree Sawaengsiriphon, Saowalak Krungchanuchat, Chalermchai Pilapong
This report presents the potential utilization of tannic acid (TA) as a natural iron chelator. TA is capable of binding with small ferric complexes without competitive binding with endogenous iron-containing molecules such as ferritin and transferrin. It was observed that the extracellular iron binding of TA resulted in the formation of self-assembled Fe3+ -TA complexes, which were then taken up by HepG2 cells via phagocytosis pathway with autophagy-inducing properties. Obviously, TA was found to inhibit iron-induced HepG2 cell growth...
March 1, 2018: European Journal of Pharmaceutical Sciences
Mehran Karimi, Fatemeh Amirmoezi, Sezaneh Haghpanah, Seyedpouria Ostad, Mehrzad Lotfi, Sepideh Sefidbakht, Shahed Rezaian
BACKGROUND: Beta-thalassemia intermediate is a genetic disease that is milder than beta-thalassemia major. The T2* magnetic resonance imaging (MRI) technique is currently the gold standard for iron load detection. However, it is expensive and needs an expert radiologist to report findings. Therefore, we conducted this study to determine an optimal cut-off value of ferritin in proportion to T2 MRI of liver and measurement of liver iron concentration for early detection of hepatic iron overload in Beta-thalassemia intermediate patients...
August 2017: Pediatric Hematology and Oncology
Gaspard d'Assignies, Anita Paisant, Edouard Bardou-Jacquet, Anne Boulic, Elise Bannier, Fabrice Lainé, Martine Ropert, Jeff Morcet, Hervé Saint-Jalmes, Yves Gandon
OBJECTIVES: To evaluate the performance and limitations of the R2* and signal intensity ratio (SIR) methods for quantifying liver iron concentration (LIC) at 3 T. METHODS: A total of 105 patients who underwent a liver biopsy with biochemical LIC (LICb ) were included prospectively. All patients underwent a 3-T MRI scan with a breath-hold multiple-echo gradient-echo sequence (mGRE). LIC calculated by 3-T SIR algorithm (LICSIR ) and by R2* (LICR2* ) were correlated with LICb ...
November 24, 2017: European Radiology
Douglas G Peters, Carson J Purnell, Michael P Haaf, Qing X Yang, James R Connor, Mark D Meadowcroft
Impaired brain iron homeostatic mechanisms, independent of pathological hallmarks, are harmful to the brain because excess free iron can cause DNA, protein, and lipid damage via oxidative stress. The goal of this study was to evaluate the longitudinal effect of chronic iron overload and deficiency in the vertebrate brain. Ten-week-old C57BL6 male mice were randomly assigned to one of four unique dietary regiments for 1 year: iron-deficient, normal iron, and two different concentrations of lipophilic iron diet containing 3,5,5-trimethylhexanoyl ferrocene (TMHF)...
November 22, 2017: Brain Structure & Function
Mei-Jou Chen, Steven Shinn-Forng Peng, Meng-Yao Lu, Yung-Li Yang, Shiann-Tarng Jou, Hsiu-Hao Chang, Shee-Uan Chen, Dong-Tsamn Lin, Kai-Hsin Lin
BackgroundTo investigate the fertility of male patients with transfusion-dependent beta-thalassemia, and to use magnetic resonance imaging (MRI) as a novel method to assess the iron overload status of testis in such patients.MethodsTwenty-one male patients with transfusion-dependent beta-thalassemia and five normal male controls enrolled in this study. Hormonal profiles, iron levels, MRI testicular dimension, MRI T2 values, parameters for sperm quality, and sperm DNA fragmentation (SDF) of participants were measured...
December 13, 2017: Pediatric Research
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