title: The Feasibility of Magnetic Resonance Imaging for Quantification of Liver, Pancreas, Spleen, Vertebral Bone Marrow, and Renal Cortex R2* and Proton Density Fat Fraction in Transfusion-Related Iron Overload.
abstract: OBJECTIVE
  We aimed to evaluate the feasibility of quantification of liver, pancreas, spleen, vertebral bone marrow, and renal cortex R2* and magnetic resonance imaging-proton density fat fraction (MRI-PDFF) and to evaluate the correlations among them in patients with transfusion-related iron overload.
  
  
  METHODS
  A total of 9 patients (5 boys, 4 girls) who were referred to our clinic with suspicion of hepatic iron overload were included in this study. All patients underwent T1-independent volumetric multi-echo gradient-echo imaging with T2* correction and spectral fat modeling. MRI examinations were performed on a 1.5 T MRI system.
  
  
  RESULTS
  All patients had hepatic iron overload. Severe hepatic iron overload was recorded in 5/9 patients (56%), and when we evaluated the PDFF maps of these patients, we observed an extensive patchy artifact in the liver in 4 of 5 patients (R2* greater than 671 Hz). When we performed MRI-PDFF measurements despite these artifacts, we observed artifactual high MRI-PDFF values. There was a close correlation between average pancreas R2* and average pancreas MRI-PDFF (p=0.003, r=0.860). There was a significant correlation between liver R2* and average pancreas R2* (p=0.021, r=0.747), liver R2* and renal cortex R2* (p=0.020, r=0.750), and average pancreas R2* and renal cortex R2* (p=0.003, r=0.858). There was a significant negative correlation between vertebral bone marrow R2* and age (p=0.018, r=-0.759).
  
  
  CONCLUSIONS
  High iron content of the liver, especially with a T2* value shorter than the first echo time can spoil the efficacy of PDFF calculation. Fat deposition in the pancreas is accompanied by pancreatic iron overload. There is a significant correlation between hepatic siderosis and pancreatic siderosis. Renal cortical and pancreatic siderosis are correlated, too.
authors.forename: İlkay S
authors.initials: İS
authors.lastname: İdilman
authors.forename: Fatma
authors.initials: F
authors.lastname: Gümrük
authors.forename: Mithat
authors.initials: M
authors.lastname: Haliloğlu
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey. E-mail : musturayk@yahoo.com.
authors.forename: Muşturay
authors.initials: M
authors.lastname: Karçaaltıncaba
mesh_terms: D000273:Adipose Tissue / Q000737:chemistry / Q000000981:diagnostic imaging; D016477:Artifacts; D001853:Bone Marrow / Q000737:chemistry / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007501:Iron / Q000032:analysis*; D019190:Iron Overload / Q000000981:diagnostic imaging* / Q000209:etiology; D007672:Kidney Cortex / Q000737:chemistry / Q000000981:diagnostic imaging*; D008099:Liver / Q000737:chemistry / Q000000981:diagnostic imaging*; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010179:Pancreas / Q000737:chemistry / Q000000981:diagnostic imaging*; D011522:Protons; D012189:Retrospective Studies; D013154:Spleen / Q000737:chemistry / Q000000981:diagnostic imaging*; D065227:Transfusion Reaction; D017086:beta-Thalassemia / Q000473:pathology / Q000628:therapy
chemical_list: D011522:Protons; D007501:Iron