SpringerLink
Log in

Evaluation of iron overload in visceral organs in thalassemia patients by point shear-wave elastography

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Introduction

The aim of this study was to investigate the value of point shear-wave elastography (pSWE) in the measurement of iron overload in the liver and other visceral organs in patients with beta thalassemia major (BTM).

Materials and methods

The study included 103 patients diagnosed with BTM who were referred to our clinic for cardiac and liver T2* measurement and a control group of 120 age- and gender-matched healthy volunteers. Cardiac and hepatic T2* measurements were performed in the patient group. Hepatic, pancreatic, splenic, and renal pSWE values were measured in both groups. The pSWE values were compared between the two groups. In the patient group, correlations between pSWE values, cardiac-hepatic T2* values and hepatic size, patient age, and serum ferritin levels were analyzed.

Results

Hepatic, pancreatic, splenic, and renal pSWE values were significantly higher in the patient group compared to the control group (p ≤ 0.001, < 0.001, 0.014, 0.026, respectively). In the patient group, hepatic pSWE values established a significant correlation with cardiac T2* values, liver size-T2*, pancreatic pSWE values, serum ferritin levels, and age (p = 0.006, < 0.001, 0.001, 0.042, 0.001, 0.032, respectively). In the ROC analysis, the area under the ROC curve was 0.807 for hepatic pSWE in the discrimination of thalassemia patients and healthy controls, and the cut-off value was 1.42, which gave a sensitivity and specificity of 75.7% and 75%, respectively.

Conclusıon

Point shear-wave elastography can be a useful technique in the clinical measurement of iron overload in the liver, pancreas, spleen, and kidney.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The data presented in this study can be obtained from the corresponding author upon request. Available data are not publicly available due to patient privacy records.

References

  1. Galanello R, Origa R (2010) Beta-thalassemia. Orphanet J Rare Dis 5:11. https://doi.org/10.1186/1750-1172-5-11

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ooi GC, Khong PL, Chan GCF et al (2004) Magnetic resonance screening of iron status in transfusion-dependent beta-thalassaemia patients. Br J Haematol 124(3):385–390. https://doi.org/10.1046/j.1365-2141.2003.04772.x

    Article  CAS  PubMed  Google Scholar 

  3. Pennell DJ, Udelson JE, Arai AE et al (2013) Cardiovascular function and treatment in β-thalassemia major: a consensus statement from the American Heart Association. Circulation 128(3):281–308. https://doi.org/10.1161/CIR.0b013e31829b2be6

    Article  CAS  PubMed  Google Scholar 

  4. Wahidiyat PA, Liauw F, Sekarsari D et al (2017) Evaluation of cardiac and hepatic iron overload in thalassemia major patients with T2* magnetic resonance imaging. Hematology 22(8):501–507. https://doi.org/10.1080/10245332.2017.1292614

    Article  CAS  PubMed  Google Scholar 

  5. Hankins JS, McCarville MB, Loeffler RB et al (2009) R2* magnetic resonance imaging of the liver in patients with iron overload. Blood 113(20):4853–4855. https://doi.org/10.1182/blood-2008-12-191643

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Wood JC (2015) Estimating tissue iron burden: current status and future prospects. Br J Haematol 170(1):15–28. https://doi.org/10.1111/bjh.13374

    Article  PubMed  PubMed Central  Google Scholar 

  7. Dighe M, Bruce M (2016) Elastography of diffuse liver diseases. Semin Roentgenol 51(4):358–366. https://doi.org/10.1053/j.ro.2016.05.002

    Article  PubMed  Google Scholar 

  8. Ferraioli G, Wong VW-S, Castera L et al (2018) Liver ultrasound elastography: an update to the World Federation for Ultrasound in Medicine and Biology guidelines and recommendations. Ultrasound Med Biol 44(12):2419–2440. https://doi.org/10.1016/j.ultrasmedbio.2018.07.008

    Article  PubMed  Google Scholar 

  9. Fraquelli M, Cassinerio E, Roghi A et al (2010) Transient elastography in the assessment of liver fibrosis in adult thalassemia patients. Am J Hematol 85(8):564–568. https://doi.org/10.1002/ajh.21752

    Article  CAS  PubMed  Google Scholar 

  10. Schenk J-P, Selmi B, Flechtenmacher C et al (2001) Real-time tissue elastography (RTE) for noninvasive evaluation of fibrosis in liver diseases in children in comparison to liver biopsy. J Med Ultrason 2014 41(4):455–462. https://doi.org/10.1007/s10396-014-0542-z

    Article  Google Scholar 

  11. Al-Khabori M, Daar S, Al-Busafi SA et al (2019) Noninvasive assessment and risk factors of liver fibrosis in patients with thalassemia major using shear wave elastography. Hematology 24(1):183–188. https://doi.org/10.1080/10245332.2018.1540518

    Article  CAS  PubMed  Google Scholar 

  12. Angelucci E, Muretto P, Nicolucci A et al (2002) Effects of iron overload and hepatitis C virus positivity in determining progression of liver fibrosis in thalassemia following bone marrow transplantation. Blood 100(1):17–21. https://doi.org/10.1182/blood.v100.1.17

    Article  CAS  PubMed  Google Scholar 

  13. Bayar N, Kurtoğlu E, Arslan Ş et al (2015) Assessment of the relationship between fragmented QRS and cardiac iron overload in patients with beta-thalassemia major. Anatol J Cardiol 15(2):132–136. https://doi.org/10.5152/akd.2014.5188

    Article  CAS  PubMed  Google Scholar 

  14. St Pierre TG, Clark PR, Chua-anusorn W et al (2005) Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood 105(2):855–861. https://doi.org/10.1182/blood-2004-01-0177

    Article  CAS  PubMed  Google Scholar 

  15. Wood JC, Enriquez C, Ghugre N et al (2005) MRI R2 and R2* map** accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood 106(4):1460–1465. https://doi.org/10.1182/blood-2004-10-3982

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Argyropoulou MI, Astrakas L (2007) MRI evaluation of tissue iron burden in patients with beta-thalassaemia major. Pediatr Radiol 37(12):1191–1199. https://doi.org/10.1007/s00247-007-0567-1

    Article  PubMed  PubMed Central  Google Scholar 

  17. Papakonstantinou O, Ladis V, Kostaridou S et al (2007) The pancreas in beta-thalassemia major: MR imaging features and correlation with iron stores and glucose disturbances. Eur Radiol 17(6):1535–1543. https://doi.org/10.1007/s00330-006-0507-8

    Article  PubMed  Google Scholar 

  18. Wood JC (2014) Use of magnetic resonance imaging to monitor iron overload. Hematol Oncol Clin North Am 28(4):747–764, vii. https://doi.org/10.1016/j.hoc.2014.04.002

    Article  PubMed  PubMed Central  Google Scholar 

  19. Queiroz-Andrade M, Blasbalg R, Ortega CD et al (2009) MR imaging findings of iron overload. Radiogr Rev Publ Radiol Soc North Am Inc 29(6):1575–1589. https://doi.org/10.1148/rg.296095511

    Article  Google Scholar 

  20. Cario H, Holl RW, Debatin K-M et al (2003) Insulin sensitivity and beta-cell secretion in thalassaemia major with secondary haemochromatosis: assessment by oral glucose tolerance test. Eur J Pediatr 162(3):139–146. https://doi.org/10.1007/s00431-002-1121-7

    Article  CAS  PubMed  Google Scholar 

  21. Koliakos G, Papachristou F, Koussi A et al (2003) Urine biochemical markers of early renal dysfunction are associated with iron overload in beta-thalassaemia. Clin Lab Haematol 25(2):105–109. https://doi.org/10.1046/j.1365-2257.2003.00507.x

    Article  CAS  PubMed  Google Scholar 

  22. Martines AMF, Masereeuw R, Tjalsma H et al (2013) Iron metabolism in the pathogenesis of iron-induced kidney injury. Nat Rev Nephrol 9(7):385–398. https://doi.org/10.1038/nrneph.2013.98

    Article  CAS  PubMed  Google Scholar 

  23. Deveci B, Kurtoglu A, Kurtoglu E et al (2016) Documentation of renal glomerular and tubular impairment and glomerular hyperfiltration in multitransfused patients with beta thalassemia. Ann Hematol 95(3):375–381. https://doi.org/10.1007/s00277-015-2561-2

    Article  CAS  PubMed  Google Scholar 

  24. Karpathios T, Antypas A, Dimitiriou P et al (1982) Spleen size changes in children with homozygous beta-thalassaemia in relation to blood transfusion. Scand J Haematol 28(3):220–226. https://doi.org/10.1111/j.1600-0609.1982.tb00518.x

    Article  CAS  PubMed  Google Scholar 

  25. Papakonstantinou O, Drakonaki EE, Maris T et al (2015) MR imaging of spleen in beta-thalassemia major. Abdom Imaging 40(7):2777–2782. https://doi.org/10.1007/s00261-015-0461-5

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Medical School, Dicle University, Diyarbakır, Turkey

    Salih Hattapoğlu & Mehmet Güli Çetinçakmak

Authors
  1. Salih Hattapoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehmet Güli Çetinçakmak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Salih Hattapoğlu.

Ethics declarations

Competing interest

The authors declare is no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hattapoğlu, S., Çetinçakmak, M.G. Evaluation of iron overload in visceral organs in thalassemia patients by point shear-wave elastography. Ir J Med Sci (2024). https://doi.org/10.1007/s11845-024-03719-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11845-024-03719-0

Keywords

Search

Navigation