Rapid Fire Abstracts
Antonella Meloni, PhD
Biomedical Engineer
Fondazione G. Monasterio CNR Regione Toscana, Italy
Antonella Meloni, PhD
Biomedical Engineer
Fondazione G. Monasterio CNR Regione Toscana, Italy
Laura Pistoia, MSc
Biologist
Fondazione Toscana Gabriele Monasterio, Italy
Davide Garamella, MD
Cardiologist
University of Pisa, Italy
Alessandro Parlato, MD
Cardiologist
University of Pisa, Italy
Vincenzo Positano, MSc
Biomedical Engineer
Fondazione Toscana Gabriele Monasterio, Italy
Gennaro Restaino, MD
Radiologist
Responsible Research Hospital, Italy
Domenico Maddaloni, MD
Hematologist
Ospedale "Engles Profili", Italy
Antonella Massa, MD
Hematologist
Ospedale “Giovanni Paolo II”, Italy
Matteo Bianchi, RT
radiology technician
Fondazione G. Monasterio CNR Regione Toscana, Italy
Raffaele De Caterina, MD, PhD
Cardiologist
University of Pisa, Italy
Alessia Pepe, MD, PhD
Prof
University of Padua, Italy
Filippo Cademartiri, MD, PhD
Radiologist
Fondazione Toscana Gabriele Monasterio, Italy
In the clinical setting the T2* technique is the method of choice for cardiac iron quantification, but all CMR relaxation times (T1, T2 and T2*) are reduced in presence of iron deposits.
We assessed the prevalence of cardiac involvement by T2* relaxometry, native T1 mapping, and T2 mapping in patients with beta-thalassemia intermedia (β-TI).
Methods:
We studied 42 β-TI patients (27 females, 39.65±12.32years), enrolled in the Extension-Myocardial Iron Overload in Thalassaemia Network.
T2* images were acquired by multiecho gradient-echo sequences, T1 images by Modified Look-Locker Inversion recovery sequences, and T2 images by multiecho fast-spin-echo sequences. Left ventricular (LV) T2*, T1 and T2 values were obtained by averaging the values in all 16 myocardial segments.
The lower limit of normal for LV T2* (32 ms), gender-specific normal ranges of T1 values, and gender- and age-specific reference values for T2 values had been previously established on a cohort of 100 healthy subjects.
Results:
A significant correlation was detected between LV T2* and T1 values, T2* and T2 values, and T1 and T2* values (Figure 1).
Mean LV T2* value was 40.06±5.59 ms. A reduced LV T2* value was found in two (4.8%) patients. Both these patients had also a reduced LV T1 value, while only one of them had a reduced LV T2 value.
Most of the patients (N=34; 81%) showed a normal LV T1 value, five (11.9%) a reduced LV T1 value, and 3 (7.1%) an increased LV T1 value. Three patients had a reduced LV T1 value in the presence of a normal LV T2* value and four had a reduced LV T1 value in the presence of a normal/increased T2 value.
Only one (2.4%) patient showed a reduced LV T2, while an increased LV T2 value was found in the 66.7% of the cases.
No patient with a normal LV T2* value had a reduced LV T2 value.
Conclusion:
In β-TI patients, native T1 mapping can improve the sensitivity in detecting mild myocardial iron loading over the T2* technique. T2 mapping does not offer any advantage in terms of sensitivity for MIO detection but can provide additional information about the subclinical myocardial inflammatory burden. Indeed, myocardial inflammation, which can be triggered also by small amounts of iron, represents the most plausible responsible for the increased T2 value found, unexpectedly, in the 66.7% of our patients. The combined use of all myocardial relaxation times can pave the way for an improved detection of early/subclinical myocardial involvement.
