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Relationship between myocardial iron concentration MRI cardiac T2* and serum ferritin levels in pediatric β-thalassemia patients
Yonathan T.T.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Beta-thalassemia (β-thalassemia) is a hereditary blood disorder requiring lifelong transfusions, leading to iron overload and subsequent organ damage. Cardiac iron accumulation is a major cause of mortality in these patients. Magnetic resonance imaging (MRI) cardiac T2* imaging is the gold standard for assessing myocardial iron concentration, but there is scarcity of studies on its relationship with serum ferritin levels. The aim of this study was to analyze the relationship between serum ferritin levels, myocardial iron concentration (MIC), and myocardial intensity using 3 Tesla cardiac MRI in pediatric β-thalassemia patients.METHODS: This observational, cross-sectional study was conducted in Makassar from November 2024 to March 2025. A total of 28 pediatric β-thalassemia patients were included. Serum ferritin levels were marked, and cardiac MRI T2* sequences were evaluated. Descriptive and correlation analyses were performed using the Mann-Whitney, χ2, Kruskal-Wallis, and Spearman tests, with statistical significance set at P<0.05.RESULTS: Serum ferritin levels ranged from 523.2 to 14,696.9 ng/mL. No significant correlation was found between serum ferritin levels with T2* and myocardial intensity on cardiac MRI (P=0.175 and P=0.541, respectively). However, myocardial intensity significantly correlated with the quantitative T2* value (P=0.002, r=0.552).CONCLUSIONS: Serum ferritin levels do not reliably reflect myocardial iron concentration in pediatric β-thalassemia patients. However, myocardial intensity on cardiac MRI T2* is significantly associated with T2* values, reinforcing its role in assessing cardiac iron overload. MRI remains as the most reliable and preferred method for evaluating cardiac iron deposition in this population.