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

  • CARDIAC RADIOLOGY
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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.

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Abbreviations

NTDT:

Non-transfusion-dependent thalassemia

TDT:

Transfusion-dependent thalassemia

MRI:

Magnetic resonance imaging

DFX:

Deferasirox

DFP:

Deferiprone

DFO:

Deferoxamine

LIC:

Liver iron concentration

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Acknowledgement

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

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Pediatrics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey

    Zeynep Karakas, Serap Karaman, Selime Aydogdu, Ayse Ozkan Karagenc & Deniz Tugcu

  2. Department of Pediatrics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey

    Yasin Yilmaz

  3. Department of Radiology, Istanbul University Istanbul Faculty of Medicine, Millet Caddesi, 34098, Istanbul, Turkey

    Zuhal Bayramoglu & Memduh Dursun

Authors
  1. Zeynep Karakas
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  2. Yasin Yilmaz
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  3. Zuhal Bayramoglu
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  4. Serap Karaman
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  5. Selime Aydogdu
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  6. Ayse Ozkan Karagenc
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  7. Deniz Tugcu
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  8. Memduh Dursun
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Corresponding author

Correspondence to Zuhal Bayramoglu.

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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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Karakas, Z., Yilmaz, Y., Bayramoglu, Z. et al. Magnetic resonance imaging during management of patients with transfusion-dependent thalassemia: a single-center experience. Radiol med 123, 572–576 (2018). https://doi.org/10.1007/s11547-018-0889-0

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  • DOI: https://doi.org/10.1007/s11547-018-0889-0

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