Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients

Reijâne Alves De Assis, Andreza Alice Feitosa Ribeiro, Fernando Uliana Kay, Laércio Alberto Rosemberg, Cesar Higa Nomura, Sandra Regina Loggetto, Aderson S. Araujo, Antonio Fabron Junior, Mônica Pinheiro De Almeida Veríssimo, Giorgio Roberto Baldanzi, Breno Pannia Espósito, Ronaldo Hueb Baroni, John C. Wood, Nelson Hamerschlak

Research output: Contribution to journalArticle

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Abstract

Purpose: To assess the correlation between MRI findings of the pancreas with those of the heart and liver in patients with beta thalassemia; to compare the pancreas T2* MRI results with glucose and ferritin levels and labile plasma iron (LPI). Materials and methods: We retrospectively evaluated chronically transfused patients, testing glucose with enzymatic tests, serum ferritin with chemiluminescence, LPI with cellular fluorescence, and T2* MRI to assess iron content in the heart, liver, and pancreas. MRI results were compared with one another and with serum glucose, ferritin, and LPI. Liver iron concentration (LIC) was determined in 11 patients' liver biopsies by atomic absorption spectrometry. Results: 289 MRI studies were available from 115 patients during the period studied. 9.4% of patients had overt diabetes and an additional 16% of patients had impaired fasting glucose. Both pancreatic and cardiac R2* had predictive power (p < 0.0001) for identifying diabetes. Cardiac and pancreatic R2* were modestly correlated with one another (r2 = 0.20, p < 0.0001). Both were weakly correlated with LIC (r2 = 0.09, p < 0.0001 for both) and serum ferritin (r2 = 0.14, p < 0.0001 and r2 = 0.03, p < 0.02, respectively). None of the three served as a screening tool for single observations. There is a strong log-log, or power-law, relationship between ratio of signal intensity (SIR) values and pancreas R2* with an r2 of 0.91. Conclusions: Pancreatic iron overload can be assessed by MRI, but siderosis in other organs did not correlate significantly with pancreatic hemosiderosis.

Original languageEnglish (US)
Pages (from-to)1465-1470
Number of pages6
JournalEuropean Journal of Radiology
Volume81
Issue number7
DOIs
StatePublished - Jul 1 2012

Fingerprint

Iron
Magnetic Resonance Imaging
Ferritins
Pancreas
Liver
Glucose
Serum
Siderosis
Hemosiderosis
Iron Overload
beta-Thalassemia
Luminescence
Fasting
Spectrum Analysis
Fluorescence
Biopsy

Keywords

  • Biopsy
  • Blood transfusion
  • Iron overload
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

De Assis, R. A., Ribeiro, A. A. F., Kay, F. U., Rosemberg, L. A., Nomura, C. H., Loggetto, S. R., ... Hamerschlak, N. (2012). Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients. European Journal of Radiology, 81(7), 1465-1470. https://doi.org/10.1016/j.ejrad.2011.03.077

Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients. / De Assis, Reijâne Alves; Ribeiro, Andreza Alice Feitosa; Kay, Fernando Uliana; Rosemberg, Laércio Alberto; Nomura, Cesar Higa; Loggetto, Sandra Regina; Araujo, Aderson S.; Fabron Junior, Antonio; De Almeida Veríssimo, Mônica Pinheiro; Baldanzi, Giorgio Roberto; Espósito, Breno Pannia; Baroni, Ronaldo Hueb; Wood, John C.; Hamerschlak, Nelson.

In: European Journal of Radiology, Vol. 81, No. 7, 01.07.2012, p. 1465-1470.

Research output: Contribution to journalArticle

De Assis, RA, Ribeiro, AAF, Kay, FU, Rosemberg, LA, Nomura, CH, Loggetto, SR, Araujo, AS, Fabron Junior, A, De Almeida Veríssimo, MP, Baldanzi, GR, Espósito, BP, Baroni, RH, Wood, JC & Hamerschlak, N 2012, 'Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients', European Journal of Radiology, vol. 81, no. 7, pp. 1465-1470. https://doi.org/10.1016/j.ejrad.2011.03.077
De Assis, Reijâne Alves ; Ribeiro, Andreza Alice Feitosa ; Kay, Fernando Uliana ; Rosemberg, Laércio Alberto ; Nomura, Cesar Higa ; Loggetto, Sandra Regina ; Araujo, Aderson S. ; Fabron Junior, Antonio ; De Almeida Veríssimo, Mônica Pinheiro ; Baldanzi, Giorgio Roberto ; Espósito, Breno Pannia ; Baroni, Ronaldo Hueb ; Wood, John C. ; Hamerschlak, Nelson. / Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients. In: European Journal of Radiology. 2012 ; Vol. 81, No. 7. pp. 1465-1470.
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AU - De Assis, Reijâne Alves

AU - Ribeiro, Andreza Alice Feitosa

AU - Kay, Fernando Uliana

AU - Rosemberg, Laércio Alberto

AU - Nomura, Cesar Higa

AU - Loggetto, Sandra Regina

AU - Araujo, Aderson S.

AU - Fabron Junior, Antonio

AU - De Almeida Veríssimo, Mônica Pinheiro

AU - Baldanzi, Giorgio Roberto

AU - Espósito, Breno Pannia

AU - Baroni, Ronaldo Hueb

AU - Wood, John C.

AU - Hamerschlak, Nelson

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N2 - Purpose: To assess the correlation between MRI findings of the pancreas with those of the heart and liver in patients with beta thalassemia; to compare the pancreas T2* MRI results with glucose and ferritin levels and labile plasma iron (LPI). Materials and methods: We retrospectively evaluated chronically transfused patients, testing glucose with enzymatic tests, serum ferritin with chemiluminescence, LPI with cellular fluorescence, and T2* MRI to assess iron content in the heart, liver, and pancreas. MRI results were compared with one another and with serum glucose, ferritin, and LPI. Liver iron concentration (LIC) was determined in 11 patients' liver biopsies by atomic absorption spectrometry. Results: 289 MRI studies were available from 115 patients during the period studied. 9.4% of patients had overt diabetes and an additional 16% of patients had impaired fasting glucose. Both pancreatic and cardiac R2* had predictive power (p < 0.0001) for identifying diabetes. Cardiac and pancreatic R2* were modestly correlated with one another (r2 = 0.20, p < 0.0001). Both were weakly correlated with LIC (r2 = 0.09, p < 0.0001 for both) and serum ferritin (r2 = 0.14, p < 0.0001 and r2 = 0.03, p < 0.02, respectively). None of the three served as a screening tool for single observations. There is a strong log-log, or power-law, relationship between ratio of signal intensity (SIR) values and pancreas R2* with an r2 of 0.91. Conclusions: Pancreatic iron overload can be assessed by MRI, but siderosis in other organs did not correlate significantly with pancreatic hemosiderosis.

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KW - Biopsy

KW - Blood transfusion

KW - Iron overload

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