Noninvasive evaluation of myocardial and hepatic iron overload by magnetic resonance: comparison of methods at 1.5 and 3.0T

• Grant number: 11/24139-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2012
• End date: July 31, 2013
• Field of knowledge: Health Sciences - Medicine - Medical Radiology
• Principal Investigator: Juliano de Lara Fernandes
• Grantee: Paulo Henrique Haddad de Souza
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Thalassemia major is a genetic hemoglobinopathy relatively frequent in Mediterranean countries and in Brazil. In its homozygous form the disease will be responsible for multiple transfusions during life. Despite an increase in life quality, these repeated transfusions lead to cumulative iron concentrations, especially in the liver. While this organ is mainly affected, cardiac complications are still responsible for complications such as heart failure. Until recently, there was no non-invasive form of evaluating iron overload in these patients. With the development of new magnetic resonance (MR) techniques, today it is possible to robustly assess both the heart and liver iron concentrations. This allowed for better therapeutical measures as well as better understanding of the pathophysiology involved in the disease. The main method to detect iron in tissues is T2*. Many different techniques for measuring T2* have been proposed but a direct comparison among these different methods have not been assessed simultaneously. Therefore, there are still some doubts regarding these techniques: (1) if all methods are interchangeable and produce the same results in the measurement of iron in the liver and heart; (2) if image acquisition in diastole with bright blood images has the same accuracy as other techniques in systole; (3) if the use of parallel imaging - which accelerates image acquisition significantly - can be used in these cases. Besides these three technical doubts, with the advent and increasing acceptance of 3.0T scanners, there are also doubts whether the use of T2* in these field strengths can provide similar results as the calibrated and widespread values provided by 1.5T scanners. The use of higher field strengths in thalassemia could be necessary in the future as well as lead to new technical advantages not yet explored. Therefore, it is also the goal of this project to simultaneously assess different T2* techniques in both 1.5T and 3.0T magnets.(AU)