Impact of MRI technique on clinical decision-making in patients with liver iron overload: comparison of FerriScan- versus R2*-derived liver iron concentration.

摘要: The purpose of this study was to compare clinical decision-making in iron overload patients using FerriScan and an R2*-based approach. One-hundred six were imaged at two consecutive timepoints (454 ± 158 days) on a 1.5-T Siemens MAGNETOM Avanto Fit scanner. For both timepoints, underwent the standard MRI protocol. During second exam, each patient additionally R2*-MRI mapping. patient, retrospective (simulated) decision made increase, decrease, or maintain chelator levels. Two different models considered: fixed threshold model assumed that adjustments are based strictly liver concentration (LIC) thresholds. Decisions with depend only most recent LIC value do not require any clinician input. utilized decisions by hematologists retrospectively trends between values. Agreement (κA) (i.e., interobserver variability) compared agreement (κB) single hematologist techniques. Good R2*- FerriScan-derived achieved for model. True positive/negative rates greater than 80%, false less 10%. ROC analysis yielded areas under curve 0.95. In model, scenarios (κA vs. κB) equal 95% confidence level. Switching estimation from has same level management as does switching one another. • management