Comparison of whole liver and small region-of-interest measurements of MRI liver R2* in children with iron overload.

Background: Measurement of liver MRI T2* and R2* is emerging as a reliable alternative to liver biopsy for the quantitation of liver iron content. A systematic investigation of the influence of the region-of-interest size and placement has not been conducted.Objective: To compare small and whole liv...

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Publicado en:Pediatric Radiology Vol. 40; no. 8; pp. 1360 - 1368
Autores principales: McCarville MB, Hillenbrand CM, Loeffler RB, Smeltzer MP, Song R, Li CS, Hankins JS, McCarville, M Beth, Hillenbrand, Claudia M, Loeffler, Ralf B, Smeltzer, Matthew P, Song, Ruitan, Li, Chin-Shang, Hankins, Jane S
Formato: clinical trial research Journal Article
Publicado: Springer Nature Aug2010
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Comparison of whole liver and small region-of-interest measurements of MRI liver R2* in children with iron overload.
      aug:
        au:
          McCarville MB
          Hillenbrand CM
          Loeffler RB
          Smeltzer MP
          Song R
          Li CS
          Hankins JS
          McCarville, M Beth
          Hillenbrand, Claudia M
          Loeffler, Ralf B
          Smeltzer, Matthew P
          Song, Ruitan
          Li, Chin-Shang
          Hankins, Jane S
        affil: Department of Radiological Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 210, Memphis, TN 38105, USA
      sug:
        subj:
          Anemia, Sickle Cell Radiography
          Magnetic Resonance Imaging
          Iron Overload Pathology
          Liver Radiography
          Adolescence
          Adult
          Child
          Human
          Liver Pathology
          Male
          Observer Bias
          Young Adult
          Clinical Trials
          Adolescent: 13-18 years
          Adult: 19-44 years
          Child: 6-12 years
          Male
      ab: Background: Measurement of liver MRI T2* and R2* is emerging as a reliable alternative to liver biopsy for the quantitation of liver iron content. A systematic investigation of the influence of the region-of-interest size and placement has not been conducted.Objective: To compare small and whole liver region-of-interest (ROI) MRI R2* values to each other and to biopsy liver iron content in patients with iron overload.Materials and Methods: Forty-one iron-overloaded patients, ages 7-35 years, underwent biopsy for liver iron content quantitation and MRI for liver R2* measurement within 30 days. Three reviewers independently used small and whole liver ROIs to measure R2*. Inter-reviewer agreement was assessed with the intra-class correlation coefficient (ICC). Associations between R2* and liver iron content were investigated using Spearman's rank-order correlation and Monte Carlo estimated exact P values.Results: Biopsy liver iron content and small and whole liver ROI R2* measurements were strongly associated for all reviewers (all P < 0.0001). Although inter-reviewer agreement was excellent for both ROI methods (ICC = 0.98-0.99), the small ROI technique more frequently led to inter-reviewer differences larger than 75 Hz, slightly higher R2* values, larger standard errors and greater range in values.Conclusion: Small and whole liver ROI techniques are strongly associated with biopsy liver iron content. We found slightly greater inter-reviewer variability in R2* values using the small ROI technique. Because such variability could adversely impact patient management when R2* values are near a threshold of iron chelation therapy, we recommend using a whole liver ROI.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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