From the Guidelines
Based on the MRI report, there is evidence of mild iron overload in the liver, with a liver iron concentration of 2.1 mg/g, which is above the normal range. The reported liver iron concentration corresponds to an R2* value of 67.73 Hz, which directly correlates with iron content in liver tissue 1. For this level of iron overload, follow-up MRI is generally recommended every 1 to 2 years to monitor changes in iron concentration, as suggested by the American Society of Hematology 2020 guidelines for sickle cell disease 1. However, the most recent and highest quality study recommends using R2*-based relaxometry for liver iron quantification, which is well validated and suitable for a wide range of iron overload severity 1. It is essential to discuss these results with your healthcare provider to determine the underlying cause of the iron overload and establish an appropriate treatment and monitoring plan based on your specific situation. Some key points to consider include:
- The use of R2* relaxometry methods that avoid fat- and noise-related biases are preferred over fat- and noise-uncorrected methods 1
- Optimized protocols with short TEs, short echo spacing, six to 12 TEs, and noise correction are recommended for R2*-based liver iron quantification 1
- Expertise in clinical liver MRI is important for interpretation of R2*-based liver iron quantification using current commercial implementations of R2*-based relaxometry 1
From the Research
Iron Overload Assessment
- The liver MRI report indicates an average R2* value of 67.73 Hz or 14.76 ms T2*, corresponding to approximately 2.1 mg/g liver iron concentration 2, 3, 4.
- According to the studies, iron overload is typically associated with liver iron concentrations above 7 mg Fe/g dry liver weight 5.
- Based on the reported liver iron concentration of 2.1 mg/g, it appears that there is no significant iron overload in this case.
Follow-up MRI Frequency
- The frequency of follow-up MRI scans depends on various factors, including the underlying condition, treatment, and local expertise 2, 4.
- Since there is no significant iron overload in this case, the need for frequent follow-up MRI scans may be limited.
- However, it is essential to consult with a healthcare professional to determine the appropriate follow-up schedule, as individual circumstances may vary 3, 6.
- It is also important to use the same MRI technique and protocol for subsequent visits to ensure comparable results 2, 4.