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  1. Hamzaini NN, Ghazali SA, Yusoff AN, Mohd Zaki F, Wan Sulaiman WNA, Dwihapsari Y
    MAGMA, 2024 Dec 12.
    PMID: 39666219 DOI: 10.1007/s10334-024-01216-0
    OBJECT: This study aimed to evaluate the relaxivity and uniformity of agarose gel phantoms added with relaxation modifiers. It is hypothesized that the modifiers could manipulate the T1 and T2 relaxations as well as the signal uniformity.

    MATERIALS AND METHODS: Twenty agarose gel phantoms with different GdCl₃ and FeCl₃ volume fractions were prepared. The phantoms were scanned using a 3-T scanner implementing a turbo spin echo sequence to acquire T1 and T2 images. The SNR of the images were computed using Image-J software from 1, 3, and 25 regions-of-interest (ROIs) and were inverted as T1 and T2 curves.

    RESULTS: With the increase in relaxation modifier content, T1 SNR increased at a faster rate at very short TR and reached saturation at TR well below 400 ms. Agarose gel phantoms containing GdCl3 showed a higher saturation value as compared to phantoms containing FeCl3. For T2 SNR, differences between plots are observed at low TE. As TE gets larger, the SNR between plots is incomparable. The SNR for both groups was uniform among 1, 3, and 25 ROIs.

    DISCUSSIONS: It can be concluded that GdCl₃ and FeCl₃ solutions can be used as effective relaxation modifiers to reduce T1 but not T2 relaxation times.

  2. Hoe HG, Git KA, Loh CK, Abdul Latiff Z, Hong J, Abdul Hamid H, et al.
    Front Radiol, 2022;2:943102.
    PMID: 37492672 DOI: 10.3389/fradi.2022.943102
    OBJECTIVE: Patients with thalassemia major do require lifetime blood transfusions that eventually result in iron accumulation in different organs. We described the usefulness of using magnetic resonance imaging (MRI) T2*imaging values for the evaluation of pancreatic iron load in these patients, and we correlated it with MRI T2* haemosiderosis of the myocardium and liver that has been recognized as a non-invasive assessment of iron overload among patients with thalassemia major.

    MATERIALS AND METHODS: We conducted a cross-sectional study on 39 patients with thalassemia major in one of the tertiary university hospitals for a 1-year period. Demographic data were collected from the patient's history. MRI T2* of the pancreas, liver, and heart were executed on all patients in the same setting. Objective values of iron overload in these organs were obtained using the MRI post-processing software from online software.

    RESULTS: A total of 32 (82.1%) patients had pancreatic iron overload including 2 patients (5.1%) with severe iron overload and 15 patients (38.5%) with moderate and mild iron overload, respectively. Nine patients (23.1%) had myocardial iron overload, which included 3 patients (7.7%) who had severe cardiac haemosiderosis. Notably, 37 patients (94.9%) had liver iron overload, which included 15 patients (38.5%) who had severe liver haemosiderosis. There was a moderate positive correlation between the relaxation time of the pancreas and heart haemosiderosis (r = 0.504, P < 0.001). No significant correlation was found between the relaxation time of the pancreas with the liver and the heart with the liver.

    CONCLUSION: Pancreatic haemosiderosis precedes cardiac haemosiderosis, which establishes a basis for initiating earlier iron chelation therapy to patients with thalassemia major.

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