CMR for myocardial iron overload quantification: calibration curve from the MIOT Network.

Objectives: R2* cardiac magnetic resonance (CMR) allows the non-invasive measurement of myocardial iron. We calibrated cardiac R2* values against myocardial tissue-measured iron concentration by using a segmental approach and we assessed the iron distribution.Methods: Five hearts of thalassemia pati...

Descripción completa

Detalles Bibliográficos
Publicado en:European Radiology Vol. 30; no. 6; pp. 3217 - 3226
Autores principales: Meloni, Antonella, Maggio, Aurelio, Positano, Vincenzo, Leto, Filippo, Angelini, Annalisa, Putti, Maria Caterina, Maresi, Emiliano, Pucci, Angela, Basso, Cristina, Marra, Martina Perazzolo, Pistoia, Laura, De Marchi, Daniele, Pepe, Alessia
Formato: Journal Article
Publicado: Springer Nature Jun2020
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143397296&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 143397296
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        09387994
        NPH
      jtl: European Radiology
      issn: 09387994
      maglogo: N
    pubinfo:
      dt: Jun2020
      vid: 30
      iid: 6
      pid: 237
      pub: Springer Nature
      place: New York, New York
    artinfo:
      ui:
        143397296
        143397296
        NLM32052169
        10.1007/s00330-020-06668-1
        NLM32052169
        143397296
      ppf: 3217
      ppct: 9
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: CMR for myocardial iron overload quantification: calibration curve from the MIOT Network.
      aug:
        au:
          Meloni, Antonella
          Maggio, Aurelio
          Positano, Vincenzo
          Leto, Filippo
          Angelini, Annalisa
          Putti, Maria Caterina
          Maresi, Emiliano
          Pucci, Angela
          Basso, Cristina
          Marra, Martina Perazzolo
          Pistoia, Laura
          De Marchi, Daniele
          Pepe, Alessia
        affil: MRI Unit, Fondazione G. Monasterio CNR-Regione Toscana, Area della Ricerca S. Cataldo, Via Moruzzi, 1, 56124, Pisa, Italy
      sug:
        subj:
          Iron Analysis
          Myocardium
          Magnetic Resonance Spectroscopy Methods
          Iron Overload Diagnosis
          Calibration
          Iron Overload Etiology
          beta-Thalassemia Complications
          Scales
          Short Portable Mental Status Questionnaire
      ab: Objectives: R2* cardiac magnetic resonance (CMR) allows the non-invasive measurement of myocardial iron. We calibrated cardiac R2* values against myocardial tissue-measured iron concentration by using a segmental approach and we assessed the iron distribution.Methods: Five hearts of thalassemia patients were donated after death/transplantation to the CoreLab of the Myocardial Iron Overload in Thalassemia Network. A multislice multiecho R2* approach was adopted. After CMR, used as guidance, the heart was cut in three short-axis slices and each slice was cut into different equiangular segments according to AHA segmentation and differentiated into endocardial and epicardial layers. Tissue iron concentration was measured by atomic absorption spectrometer technique.Results: Fifty-five samples were used since only for two hearts all the 16 samples were analyzed. Mean iron concentration was 4.71 ± 4.67 mg/g dw. Segmental iron levels ranged from 0.24 to 13.78 mg/g dw. The coefficient of variability of iron for myocardial segments ranged from 8.08 to 24.54% (mean 13.49 ± 6.93%). Iron concentration was significantly higher in the epicardial than in the endocardial layer (5.99 ± 6.01 vs 4.84 ± 4.87 mg/g dw; p = 0.042). Four different circumferential regions (anterior, septal, inferior, and lateral) were defined. A circumferential heterogeneity was noted, with more iron in the anterior region, followed by the inferior region. The direct nonlinear fitting of R2* and [Fe] data led to the calibration curve: [Fe] = 0.0022 ∙ (R2*-ROI)1.462 (R-square = 0.956).Conclusions: Our data further validate R2* CMR using a segmental approach as a sensitive and early technique for quantifying iron distribution in the current clinical practice.Key Points: • Calibration in humans for cardiovascular magnetic resonance R2* against myocardial iron concentration was provided. • A circumferential heterogeneity in cardiac iron distribution was detected: more iron was observed in the anterior region, followed by the inferior region. This finding corroborates the use of a segmental T2* CMR approach in the clinical practice to detect a heterogeneous iron distribution. • The comparison between the cardiac T2* values obtained with the region-based and the pixel-wise approaches showed a significant correlation and no significant difference but, in presence of significant iron load, the region-based approach resulted in significantly higher T2* values.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N