title: MRI for Quantification of Liver and Cardiac Iron in Thalassemia Major Patients: Pilot Study in Indian Population.
abstract: OBJECTIVE
  To evaluate Magnetic resonance imaging (MRI) as a tool to quantify liver and cardiac iron in Indian population with thalassemia major, and correlate liver and cardiac iron values with that of serum ferritin (SF).
  
  
  METHODS
  Fifty patients aged between 8 to 18 y, with thalassemia major on regular blood transfusions and oral iron chelation therapy were enroled in the study. Twenty patients within the same age group, having no history of blood transfusions and no liver or cardiac disease were taken as controls. T2* MRI of heart and liver and SF estimation was done for all the cases as well as controls. All MRI scans were done on a 1.5-T Siemens MRI scanner using body coil.
  
  
  RESULTS
  The mean SF among cases was 2150 ng/ml (SD 2179). Significant correlation was found in patients between liver iron concentration (LIC, mean 15) and SF levels (r = 0.522; p < 0.001), and also significant but weaker correlation was found in patients between myocardial iron concentration (MIC, mean 1.3) and SF levels (r = 0.483; p < 0.001). Seventeen (34%) patients had a SF of <1000 ng/ml. Of these, 11 and 3 patients respectively had LIC and MIC more than normal range.
  
  
  CONCLUSIONS
  T2* MRI is a valuable non-invasive tool for quantification of liver and cardiac iron deposition in patients with thalassemia major. It can demonstrate high LIC and MIC, even though the targeted SF levels are low in thalassemia, indicating the need for escalation of the chelation therapy. This needs to be confirmed on full-fledged larger prospective studies.
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Mandal
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India. sodhiks@gmail.com.
authors.forename: Kushaljit Singh
authors.initials: KS
authors.lastname: Sodhi
authors.affiliation: Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Bansal
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
authors.forename: Anindita
authors.initials: A
authors.lastname: Sinha
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
authors.forename: Anmol
authors.initials: A
authors.lastname: Bhatia
authors.affiliation: Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Amita
authors.initials: A
authors.lastname: Trehan
authors.affiliation: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005293:Ferritins / Q000097:blood; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007501:Iron / Q000378:metabolism*; D019190:Iron Overload / Q000175:diagnosis*; D008099:Liver / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D010865:Pilot Projects; D011446:Prospective Studies; D013789:Thalassemia / Q000000981:diagnostic imaging* / Q000378:metabolism*
chemical_list: D005293:Ferritins; D007501:Iron
keywords: Cardiac; Ferritin; Liver; MRI; T2*