This article is more than 5 years old. Information may no longer be current.

MRI more accurate for measuring total body iron vs. liver biopsy

Using magnetic resonance imaging, or MRI, was more accurate and effective in measuring total body iron balance compared with liver biopsy, according to newly published data.

“Measuring total body iron using MRI is safer and less painful than biopsy,” John Wood, MD, PhD, cardiologist and biomedical engineer at Children’s Hospital Los Angeles and professor of pediatrics at Keck School of Medicine, University of Southern California, said in a press release. “In this study, we’ve demonstrated that it is also more accurate. MRI should be recognized as the new ‘gold standard’ for determining iron accumulation in the body.”

John Wood

Wood and colleagues analyzed data of 49 patients enrolled in a previous phase 2 clinical trial of deferitazole. Forty-nine patients received deferitazole for 24 weeks, 39 patients completed 48 weeks of therapy and 26 finished the 2-year extension study. The researchers used serial estimates of iron chelation efficiency (ICE) calculated by R2 and R2* MRI liver iron concentration (LIC) estimates through simulation of liver biopsy to compare the techniques, according to the research. Liver iron was measured at baseline, 3 months, 6 months, 12 months and 24 months.  

At 48-week intervals, LIC estimates using R2, R2* and liver biopsy displayed statistically identical variances. However, MRI measures were found more accurate thans realistic sampling error for liver biopsy (Coefficient of Variation between 10% and 40%), according to the research. LIC estimates using R2 had the most powerful ICE estimates at 12 and 24 weeks, but was not significantly different at 48 weeks.

“We demonstrate that MRI relaxometry produces LIC estimates that are better for monitoring individual patient response to iron chelation therapy than values produced by physically- achievable liver biopsy,” the researchers wrote. “We conclude that well-controlled MRI relaxometry metrics should replace liver biopsy as a surrogate for chelator effectiveness in clinical trials and that indications for liver biopsy should be restricted for assessment of tissue histology.” – by Melinda Stevens  

Disclosure: Wood is a consultant for Shire, ApoPharma and Biomed Informatics; he has received research funding from Shire and the NIH; and has received speaker reimbursements from Novartis and ApoPharma. Please see the full study for a full list of all other authors’ relevant financial disclosures.