title: Value of severe liver iron overload for assessing heart iron levels in thalassemia major patients.
abstract: The relationship between severe liver iron overload (LIO) and heart iron overload (HIO) in transfusion-dependent patients with thalassemia major (TM) is uncertain. Whether severe LIO can serve as an index for assessing heart iron deposition has vital clinical significance. Therefore, our aim is to determine if a close relationship exists between severe LIO and HIO.
  
  
  
  We examined 110 TM patients who underwent T2* measurement in the liver and heart on a 1.5 Tesla MRI scanner. Various statistical analysis methods were used to assess the relationship.
  
  
  
  Most of these patients suffered from severe LIO (58.18%, liver T2* < 1.4 ms). Both Pearson's and Spearman's tests showed a significant correlation between liver T2* and heart T2* values (with a correlation coefficient of 0.408 and 0.550, respectively, both P < 0.0001). A nonlinear model, with the equation of Heart T2* = 37.974-17.684 / Liver T2*, was found to be the best model to indicate the relationship between liver T2* and heart T2*. Receiver operating characteristic (ROC) analysis showed the area under the ROC curve of liver T2* and serum ferritin for predicting HIO was 0.812 (95% confidence interval [CI]: 0.731-0.892; P < 0.0001) and 0.69 (95% CI: 0.585-0.795; P = 0.001), respectively.
  
  
  
  Our preliminary data suggest the existence of a close relationship between severe LIO and HIO. High liver iron levels appear to increase the risk of heart iron deposition. This further supports the concept of critical liver iron concentration, above which elevated heart iron is present. J. MAGN. RESON. IMAGING 2016;44:880-889.
authors.affiliation: Department of Radiology, Affiliated hospital of Guangdong Medical College, Guangdong, China.|Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.|Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Chen
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Qihua
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Radiology, Affiliated hospital of Guangdong Medical College, Guangdong, China.
authors.forename: Zebin
authors.initials: Z
authors.lastname: Luo
authors.affiliation: Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong, China.
authors.forename: Zuoquan
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Ziliang
authors.initials: Z
authors.lastname: Cheng
authors.affiliation: Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Jiaji
authors.initials: J
authors.lastname: Mao
authors.affiliation: Philips Healthcare, Hong Kong, China.
authors.forename: Queenie
authors.initials: Q
authors.lastname: Chan
authors.affiliation: Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Honggui
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China. liangbl@163.net.
authors.forename: Biling
authors.initials: B
authors.lastname: Liang
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China. huaguo@tsinghua.edu.cn.
authors.forename: Hua
authors.initials: H
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism*; D019190:Iron Overload / Q000000981:diagnostic imaging / Q000378:metabolism*; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014018:Tissue Distribution; D055815:Young Adult; D017086:beta-Thalassemia / Q000000981:diagnostic imaging / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D007501:Iron
keywords: MRI; heart; iron overload; liver