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La radiologia medica

, Volume 123, Issue 8, pp 572–576 | Cite as

Magnetic resonance imaging during management of patients with transfusion-dependent thalassemia: a single-center experience

  • Zeynep Karakas
  • Yasin Yilmaz
  • Zuhal Bayramoglu
  • Serap Karaman
  • Selime Aydogdu
  • Ayse Ozkan Karagenc
  • Deniz Tugcu
  • Memduh Dursun
CARDIAC RADIOLOGY

Abstract

Background

Cardiac and hepatic magnetic resonance imaging evaluation during treatment can tailor physicians’ chelation therapy titrations.

Aim

The aim of the study was to assess the relationship of cardiac and hepatic T2* values with chelation therapy in patients with transfusion-dependent thalassemia (TDT).

Methods

A total of 106 patients with TDT who were followed up in Istanbul Medical Faculty Thalassemia Center were evaluated for the study. Forty-eight (45%) patients with TDT had more than one consecutive MRI examination. The patients were divided into three subgroups according to the cardiac T2* values as the high-risk group (T2* MRI < 10 ms), medium-risk group (T2* MRI 10-20 ms), and the low-risk group (T2* MRI > 20 ms).

Results

The majority of patients used DFX (deferasirox) (79%) and deferiprone (DFP) (17%). Approximately 80% of patients according to cardiac T2* value and 40% of patients according to hepatic T2* value were initially in the low-risk group. Patients with follow-up MRI examinations exhibited significant improvement in liver iron concentration, which correlated with an increase in hepatic T2* values. The decrease of liver iron concentration was prominent in the DFX group (p < 0.01). The serum ferritin level was significantly correlated with liver iron concentrations (rs = 0.65, p < 0.001), hepatic T2* value (rs = − 0.62, p < 0.001), but not with cardiac T2* value (rs = − 0.20, p = 0.07).

Conclusion

Cardiovascular and hepatic MRI is a useful follow-up tool during the assessment of risk groups and chelation therapy of patients with TDT. Consecutive MRI tests showed good monitoring of cardiac and liver iron overload.

Keywords

Thalassemia Cardiovascular magnetic resonance Hepatic magnetic resonance Chelation therapy 

Abbreviations

NTDT

Non-transfusion-dependent thalassemia

TDT

Transfusion-dependent thalassemia

MRI

Magnetic resonance imaging

DFX

Deferasirox

DFP

Deferiprone

DFO

Deferoxamine

LIC

Liver iron concentration

Notes

Acknowledgement

We gratefully thank Mr. David Chapman for kindly providing language revision.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board (Istanbul University, Istanbul Medical Faculty Clinical Research Ethics Committee).

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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  • Zeynep Karakas
    • 1
  • Yasin Yilmaz
    • 2
  • Zuhal Bayramoglu
    • 3
  • Serap Karaman
    • 1
  • Selime Aydogdu
    • 1
  • Ayse Ozkan Karagenc
    • 1
  • Deniz Tugcu
    • 1
  • Memduh Dursun
    • 3
  1. 1.Division of Hematology and Oncology, Department of PediatricsIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
  2. 2.Department of PediatricsIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
  3. 3.Department of RadiologyIstanbul University Istanbul Faculty of MedicineIstanbulTurkey

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