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

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.

• Authors: Zeynep Karakas, Yasin Yilmaz, Zuhal Bayramoglu, Serap Karaman, Selime Aydogdu, Ayse Ozkan Karagenc, Deniz Tugcu, Memduh Dursun
• Journal: La Radiologia medica (Radiol Med) Vol. 123 Issue 8 Pg. 572-576 (Aug 2018) ISSN: 1826-6983 [Electronic] Italy
• PMID: 29663188 (Publication Type: Journal Article)

Chemical References

• Benzoates
• Iron Chelating Agents
• Pyridones
• Triazoles
• Deferiprone
• Deferasirox

Topics

• Adolescent
• Adult
• Benzoates (therapeutic use)
• Blood Component Transfusion
• Chelation Therapy (methods)
• Child
• Deferasirox
• Deferiprone
• Female
• Humans
• Iron Chelating Agents (therapeutic use)
• Iron Overload (diagnostic imaging, drug therapy)
• Liver (metabolism)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Myocardium (metabolism)
• Pyridones (therapeutic use)
• Retrospective Studies
• Thalassemia (therapy)
• Treatment Outcome
• Triazoles (therapeutic use)
• Turkey