Liver iron concentration measurements by MRI in chronically transfused children with sickle cell anemia: baseline results from the TWiTCH trial.
Liver iron concentration measurements by MRI in chronically transfused children with sickle cell anemia: baseline results from the TWiTCH trial.
复制标题
DOI：
10.1002/ajh.24089
复制
发表时间：
2015-09
影响因子：
12.8
通讯作者：
TWiTCH Investigators
中科院分区：
文献类型：
--
作者：
Wood JC;Pressel S;Rogers ZR;Odame I;Kwiatkowski JL;Lee MT;Owen WC;Cohen AR;St Pierre T;Heeney MM;Schultz WH;Davis BR;Ware RE;TWiTCH Investigators
MRI无创、定量和准确地评估肝脏铁浓度(LIC)对接受输血的患者是有用的，但R2和R2*MRI技术在镰状细胞性贫血(SCA)中尚未进行系统比较。我们报告了Twitch试验的基线LIC结果，该试验比较了羟基脲和输血治疗对儿童SCA患者的初级卒中预防的影响。肝脏R2的采集和处理使用FDA批准的商业流程(FerriScan®)，而肝脏R2*的质量控制和处理由核心实验室执行，对临床现场和患者数据视而不见。使用这两种MRI技术的基线LIC研究适用于120名参与者。LICR2*与LICR2结果高度相关(R2=0.93)。观察到LIC(R2*)/LIC(R2)的比例偏差随LIC平均值的降低而减小。MRI制造商也观察到了LICR2*和LICR2之间的系统差异。重要的是，LICR2*和LICR2估计彼此之间有95%的广泛一致限度。我们建议在SCA患者中不要交替使用LICR2和LICR2*，以跟踪个别患者铁负荷的趋势。
Non-invasive, quantitative, and accurate assessment of liver iron concentration (LIC) by MRI is useful for patients receiving transfusions, but R2 and R2* MRI techniques have not been systematically compared in sickle cell anemia (SCA). We report baseline LIC results from the TWiTCH trial, which compares hydroxyurea with blood transfusion treatment for primary stroke prophylaxis assessed by transcranial Doppler sonography in pediatric SCA patients. Liver R2 was collected and processed using a FDA-approved commercial process (FerriScan®), while liver R2* quality control and processing were performed by a Core Laboratory blinded to clinical site and patient data. Baseline LIC studies using both MRI techniques were available for 120 participants. LICR2* and LICR2 results were highly correlated (r2 = 0.93). A proportional bias of LIC(R2*)/LIC(R2), decreasing with average LIC, was observed. Systematic differences between LICR2* and LICR2 were also observed by MRI manufacturer. Importantly, LICR2* and LICR2 estimates had broad 95% limits of agreement with respect to each other. We recommend LICR2 and LICR2* not be used interchangeably in SCA patients to follow individual patient trends in iron burden.