The worth of diffusion-weighted imaging for quantifying liver iron concentration in transfusion-dependent thalassemia patients

Abstract

Background Magnetic resonance imaging (MRI) is currently the primary method for evaluating liver iron concentration (LIC); however, most techniques necessitate intricate data post-processing. Consequently, the development of simple quantitative methods is highly desirable. Purpose To investigate the value of diffusion-weighted imaging (DWI) for quantifying LIC in patients with transfusion-dependent thalassemia (TDT). Material and Methods Data were collected on patients with TDT, including conventional MRI iron quantification sequences such as FerriScan R2, T2*, and DWI data. The liver's apparent diffusion coefficient (ADC) and T2* values were measured, and these measurements were compared to the LIC reports obtained from MRI-R2/FerriScan, which are U.S. Food and Drug Administration certified, to evaluate the utility of ADC values in quantitatively assessing LIC. Results Among the 58 patients with TDT, the linear regression analysis indicated R 2 values in the range of approximately 0.4765–0.6022 for ADC values and LIC, with non-linear regression R 2 in the range of 0.6263–0.6479. The T2* model demonstrated excellent diagnostic accuracy for extremely severe liver iron overload with an area under the receiver operating characteristic curve (AUC) of 0.996, whereas the ADC model exhibited a similarly high AUC in the range of 0.891–0.941. Conclusion In patients with known hepatic iron overload due to TDT, ADC values show a correlation with liver iron content and have the potential to serve as a supplementary method for quantitative measurement of liver iron by T2*/R2*.