title: Evaluation of cardiac and hepatic iron overload in thalassemia major patients with T2* magnetic resonance imaging.
abstract: OBJECTIVE
  Recent advancements have promoted the use of T2* magnetic resonance imaging (MRI) in the non-invasive detection of iron overload in various organs for thalassemia major patients. This study aims to determine the iron load in the heart and liver of patients with thalassemia major using T2* MRI and to evaluate its correlation with serum ferritin level and iron chelation therapy.
  
  
  METHODS
  This cross-sectional study included 162 subjects diagnosed with thalassemia major, who were classified into acceptable, mild, moderate, or severe cardiac and hepatic iron overload following their T2* MRI results, respectively, and these were correlated to their serum ferritin levels and iron chelation therapy.
  
  
  RESULTS
  The study found that 85.2% of the subjects had normal cardiac iron stores. In contrast, 70.4% of the subjects had severe liver iron overload. A significant but weak correlation (r = -0.28) was found between cardiac T2* MRI and serum ferritin, and a slightly more significant correlation (r = 0.37) was found between liver iron concentration (LIC) and serum ferritin.
  
  
  CONCLUSIONS
  The findings of this study are consistent with several other studies, which show that patients generally manifest with liver iron overload prior to cardiac iron overload. Moreover, iron accumulation demonstrated by T2* MRI results also show a significant correlation to serum ferritin levels.
  
  
  CONCLUSIONS
  This is the first study of its kind conducted in Indonesia, which supports the fact that T2* MRI is undoubtedly valuable in the early detection of cardiac and hepatic iron overload in thalassemia major patients.
authors.affiliation: a Pediatric Hematology-Oncology Division, Department of Child Health, Faculty of Medicine , Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital , Jakarta , Indonesia.
authors.forename: Pustika Amalia
authors.identifier: http://orcid.org/0000-0002-5513-006X
authors.initials: PA
authors.lastname: Wahidiyat
authors.affiliation: b Department of Child Health, Faculty of Medicine , Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital , Jakarta , Indonesia.
authors.forename: Felix
authors.initials: F
authors.lastname: Liauw
authors.affiliation: c Department of Radiology, Faculty of Medicine , Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital , Jakarta , Indonesia.
authors.forename: Damayanti
authors.initials: D
authors.lastname: Sekarsari
authors.affiliation: b Department of Child Health, Faculty of Medicine , Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital , Jakarta , Indonesia.
authors.forename: Siti Ayu
authors.initials: SA
authors.lastname: Putriasih
authors.affiliation: d University of Southern California, Keck School of Medicine Children's Hospital , Los Angeles , USA.
authors.forename: Vasili
authors.initials: V
authors.lastname: Berdoukas
authors.affiliation: e CMR Unit , Royal Brompton Hospital , London , United Kingdom.
authors.forename: Dudley J
authors.initials: DJ
authors.lastname: Pennell
mesh_terms: D015913:Chelation Therapy; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D005293:Ferritins / Q000097:blood; D006334:Heart Function Tests; D006801:Humans; D007501:Iron / Q000378:metabolism; D019190:Iron Overload / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D008099:Liver / Q000378:metabolism* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology*; D017086:beta-Thalassemia / Q000150:complications*
chemical_list: D005293:Ferritins; D007501:Iron
keywords: T2* MRI; cardiac iron; hepatic iron; thalassemia major