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Erschienen in: Pediatric Radiology 8/2011

01.08.2011 | Original Article

Noninvasive measurement of liver iron concentration at MRI in children with acute leukemia: initial results

verfasst von: Tibor Vag, Karim Kentouche, Ines Krumbein, Jürgen R. Reichenbach, Eric Lopatta, Diane M. Renz, Martin Stenzel, James Beck, Werner A. Kaiser, Hans-Joachim Mentzel

Erschienen in: Pediatric Radiology | Ausgabe 8/2011

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Abstract

Background

Routine assessment of body iron load in patients with acute leukemia is usually done by serum ferritin (SF) assay; however, its sensitivity is impaired by different conditions including inflammation and malignancy.

Objective

To estimate, using MRI, the extent of liver iron overload in children with acute leukemia and receiving blood transfusions, and to examine the association between the degree of hepatic iron overload and clinical parameters including SF and the transfusion iron load (TIL).

Material and methods

A total of 25 MRI measurements of the liver were performed in 15 children with acute leukemia (mean age 9.75 years) using gradient-echo sequences. Signal intensity ratios between the liver and the vertebral muscle (L/M ratio) were calculated and compared with SF-levels. TIL was estimated from the cumulative blood volume received, assuming an amount of 200 mg iron per transfused red blood cell unit.

Results

Statistical analysis revealed good correlation between the L/M SI ratio and TIL (r = −0.67, P = 0.002, 95% confidence interval CI = −0.83 to −0.34) in patients with acute leukemia as well as between L/M SI ratio and SF (r = −0.76, P = 0.0003, 95% CI = −0.89 to −0.52).

Conclusion

SF may reliably reflect liver iron stores as a routine marker in patients suffering from acute leukemia
Literatur
1.
Zurück zum Zitat Batts KP (2007) Iron overload syndromes and the liver. Mod Pathol Suppl 1:31–39CrossRef Batts KP (2007) Iron overload syndromes and the liver. Mod Pathol Suppl 1:31–39CrossRef
2.
Zurück zum Zitat Adamkiewicz TV, Abboud MR, Paley C et al (2009) Serum ferritin level changes in children with sickle cell disease on chronic blood transfusion are nonlinear and are associated with iron load and liver injury. Blood 114:4632–4638PubMedCrossRef Adamkiewicz TV, Abboud MR, Paley C et al (2009) Serum ferritin level changes in children with sickle cell disease on chronic blood transfusion are nonlinear and are associated with iron load and liver injury. Blood 114:4632–4638PubMedCrossRef
3.
Zurück zum Zitat Matzner Y, Konijn AM, Hershko C (1980) Serum ferritin in hematologic malignancies. Am J Hematol 9:13–22PubMedCrossRef Matzner Y, Konijn AM, Hershko C (1980) Serum ferritin in hematologic malignancies. Am J Hematol 9:13–22PubMedCrossRef
4.
Zurück zum Zitat Armand P, Kim HT, Cutler CS et al (2007) Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation. Blood 109:4586–4588PubMedCrossRef Armand P, Kim HT, Cutler CS et al (2007) Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation. Blood 109:4586–4588PubMedCrossRef
5.
Zurück zum Zitat Au WY, Lam WM, Chu WC et al (2007) A magnetic resonance imaging study of iron overload in hemopoietic stem cell transplant recipients with increased ferritin levels. Transplant Proc 39:3369–3374PubMedCrossRef Au WY, Lam WM, Chu WC et al (2007) A magnetic resonance imaging study of iron overload in hemopoietic stem cell transplant recipients with increased ferritin levels. Transplant Proc 39:3369–3374PubMedCrossRef
6.
Zurück zum Zitat Papakonstantinou OG, Maris TG, Kostaridou V et al (1995) Assessment of liver iron overload by T2-quantitative magnetic resonance imaging: correlation of T2-QMRI measurements with serum ferritin concentration and histologic grading of siderosis. Magn Reson Imaging 13:967–977PubMedCrossRef Papakonstantinou OG, Maris TG, Kostaridou V et al (1995) Assessment of liver iron overload by T2-quantitative magnetic resonance imaging: correlation of T2-QMRI measurements with serum ferritin concentration and histologic grading of siderosis. Magn Reson Imaging 13:967–977PubMedCrossRef
7.
Zurück zum Zitat Leung AWK, Chu WCW, Lam WWM et al (2009) Magnetic resonance imaging assessment of cardiac and liver iron load in transfusion dependent patients. Pediatr Blood Cancer 53:1054–1059PubMedCrossRef Leung AWK, Chu WCW, Lam WWM et al (2009) Magnetic resonance imaging assessment of cardiac and liver iron load in transfusion dependent patients. Pediatr Blood Cancer 53:1054–1059PubMedCrossRef
8.
Zurück zum Zitat Wood JC, Enriquez C, Ghugre N et al (2005) MRI R2 and R2* mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood 106:1460–1465PubMedCrossRef Wood JC, Enriquez C, Ghugre N et al (2005) MRI R2 and R2* mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood 106:1460–1465PubMedCrossRef
9.
Zurück zum Zitat Maris TG, Papakonstantinou O, Chatzimanoli V et al (2007) Myocardial and liver iron status using a fast T*2 quantitative MRI (T*2qMRI) technique. Magn Reson Med 57:742–753PubMedCrossRef Maris TG, Papakonstantinou O, Chatzimanoli V et al (2007) Myocardial and liver iron status using a fast T*2 quantitative MRI (T*2qMRI) technique. Magn Reson Med 57:742–753PubMedCrossRef
10.
Zurück zum Zitat Gandon Y, Olivié D, Guyader D et al (2004) Non-invasive assessment of hepatic iron stores by MRI. Lancet 363:357–362PubMedCrossRef Gandon Y, Olivié D, Guyader D et al (2004) Non-invasive assessment of hepatic iron stores by MRI. Lancet 363:357–362PubMedCrossRef
11.
Zurück zum Zitat Olthof AW, Sijens PE, Kreeftenberg HG et al (2009) Non-invasive liver iron concentration measurement by MRI: comparison of two validated protocols. Eur J Radiol 71:116–121PubMedCrossRef Olthof AW, Sijens PE, Kreeftenberg HG et al (2009) Non-invasive liver iron concentration measurement by MRI: comparison of two validated protocols. Eur J Radiol 71:116–121PubMedCrossRef
12.
Zurück zum Zitat St Pierre TG, Clark PR, Chua-anusorn W et al (2005) Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood 105:855–861PubMedCrossRef St Pierre TG, Clark PR, Chua-anusorn W et al (2005) Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood 105:855–861PubMedCrossRef
13.
Zurück zum Zitat Schwenzer NF, Machann J, Haap MM et al (2008) T2* relaxometry in liver, pancreas, and spleen in a healthy cohort of one hundred twenty-nine subjects-correlation with age, gender, and serum ferritin. Invest Radiol 43:854–860PubMedCrossRef Schwenzer NF, Machann J, Haap MM et al (2008) T2* relaxometry in liver, pancreas, and spleen in a healthy cohort of one hundred twenty-nine subjects-correlation with age, gender, and serum ferritin. Invest Radiol 43:854–860PubMedCrossRef
14.
Zurück zum Zitat Christoforidis A, Haritandi A, Tsitouridis I et al (2006) Correlative study of iron accumulation in liver, myocardium, and pituitary assessed with MRI in young thalassemic patients. J Pediatr Hematol Oncol 28:311–315PubMedCrossRef Christoforidis A, Haritandi A, Tsitouridis I et al (2006) Correlative study of iron accumulation in liver, myocardium, and pituitary assessed with MRI in young thalassemic patients. J Pediatr Hematol Oncol 28:311–315PubMedCrossRef
15.
Zurück zum Zitat Argyropoulou MI, Kiortsis DN, Astrakas L et al (2007) Liver, bone marrow, pancreas and pituitary gland iron overload in young and adult thalassemic patients: a T2 relaxometry study. Eur Radiol 17:3025–3030PubMedCrossRef Argyropoulou MI, Kiortsis DN, Astrakas L et al (2007) Liver, bone marrow, pancreas and pituitary gland iron overload in young and adult thalassemic patients: a T2 relaxometry study. Eur Radiol 17:3025–3030PubMedCrossRef
16.
Zurück zum Zitat Halonen P, Mattila J, Suominen P et al (2003) Iron overload in children who are treated for acute lymphoblastic leukemia estimated by liver siderosis and serum iron parameters. Pediatrics 111:91–96PubMedCrossRef Halonen P, Mattila J, Suominen P et al (2003) Iron overload in children who are treated for acute lymphoblastic leukemia estimated by liver siderosis and serum iron parameters. Pediatrics 111:91–96PubMedCrossRef
17.
Zurück zum Zitat Lipschitz DA, Cook JD, Finch CA (1974) A clinical evaluation of serum ferritin as an index of iron stores. N Engl J Med 290:1213–1216PubMedCrossRef Lipschitz DA, Cook JD, Finch CA (1974) A clinical evaluation of serum ferritin as an index of iron stores. N Engl J Med 290:1213–1216PubMedCrossRef
18.
Zurück zum Zitat Alexopoulou E, Stripeli F, Baras P et al (2006) R2 relaxometry with MRI for the quantification of tissue iron overload in beta-thalassemic patients. J Magn Reson Imaging 23:163–170PubMedCrossRef Alexopoulou E, Stripeli F, Baras P et al (2006) R2 relaxometry with MRI for the quantification of tissue iron overload in beta-thalassemic patients. J Magn Reson Imaging 23:163–170PubMedCrossRef
19.
Zurück zum Zitat Kohgo Y, Ikuta K, Ohtake T et al (2008) Body iron metabolism and pathophysiology of iron overload. Int J Hematol 88:7–15PubMedCrossRef Kohgo Y, Ikuta K, Ohtake T et al (2008) Body iron metabolism and pathophysiology of iron overload. Int J Hematol 88:7–15PubMedCrossRef
20.
Zurück zum Zitat McCarville MB, Hillebrand CM, Loeffler RB et al (2010) Comparison of whole liver and small region of interest measurements of MRI liver R2* in children with high iron overload. Pediatr Radiol 40:1360–1367PubMedCrossRef McCarville MB, Hillebrand CM, Loeffler RB et al (2010) Comparison of whole liver and small region of interest measurements of MRI liver R2* in children with high iron overload. Pediatr Radiol 40:1360–1367PubMedCrossRef
Metadaten
Titel
Noninvasive measurement of liver iron concentration at MRI in children with acute leukemia: initial results
verfasst von
Tibor Vag
Karim Kentouche
Ines Krumbein
Jürgen R. Reichenbach
Eric Lopatta
Diane M. Renz
Martin Stenzel
James Beck
Werner A. Kaiser
Hans-Joachim Mentzel
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 8/2011
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-011-2122-3

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