title: Iron overload of hematological origin: validation of a screening procedure for cardiac overload by MRI in routine clinical practice.
abstract: OBJECTIVE
  Screening for cardiac iron overload is generally done by magnetic resonance imaging (MRI) and demonstrated by a shortening of the myocardial T2* below 20 ms at 1.5 Tesla. This measurement was validated with a specific sequence and the CMRTools(®) calculation software (reference technique). The objective of this study was to validate the use of sequences and software programs that are available in routine clinical practice to screen for iron overload.
  
  
  METHODS
  First, a phantom of 11 tubes with a T2* between 4 and 33 ms was tested at three sites that had MRI machines of different brands. Second, the myocardial T2* values of 75 patients were measured in routine clinical practice using two methods. The first method used the reference sequence specially installed in the machines associated with the CMRTool software. The second method used the standard acquisition sequences available in the machines followed by calculation on a computer spreadsheet.
  
  
  RESULTS
  In the phantom, the mean of the differences in T2* between each machine was 0.6 ms. Thirteen patients had a lowered T2* value with the reference technique. Three cases were poorly classified using the routine technique and corresponded with false positives of low overload (T2* between 18 and 20 ms).
  
  
  CONCLUSIONS
  Screening for myocardial iron overload can be done by MRI by using sequences and calculation software available in routine clinical practice during the same examination as the one for the evaluation of hepatic iron overload.
authors.affiliation: Radiology Department, Hôpital Huriez, INSERM U703, CHRU de Lille, 1 rue Polonovski, 59037 Lille, France. olivier.ernst@chru-lille.fr
authors.forename: O
authors.initials: O
authors.lastname: Ernst
authors.forename: I
authors.initials: I
authors.lastname: Thuret
authors.forename: P
authors.initials: P
authors.lastname: Petit
authors.forename: F
authors.initials: F
authors.lastname: Ameur
authors.forename: A D
authors.initials: AD
authors.lastname: Loundou
authors.forename: E
authors.initials: E
authors.lastname: de Kerviler
authors.forename: R
authors.initials: R
authors.lastname: Izzillo
authors.forename: A L
authors.initials: AL
authors.lastname: Willig
authors.forename: L
authors.initials: L
authors.lastname: Pascal
authors.forename: S
authors.initials: S
authors.lastname: Verlhac
authors.forename: S
authors.initials: S
authors.lastname: Mordon
authors.forename: P
authors.initials: P
authors.lastname: Fenaux
authors.forename: C
authors.initials: C
authors.lastname: Rose
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D005260:Female; D005293:Ferritins / Q000097:blood; D006333:Heart Failure / Q000175:diagnosis*; D006346:Heart Septum / Q000473:pathology; D006432:Hemochromatosis / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019190:Iron Overload / Q000175:diagnosis*; D008099:Liver / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods*; D008432:Mathematical Computing; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D019047:Phantoms, Imaging; D012016:Reference Values; D012984:Software; D055815:Young Adult
chemical_list: D005293:Ferritins