Kidney R2* Mapping for Noninvasive Evaluation of Iron Overload in Paroxysmal Nocturnal Hemoglobinuria

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  • Ito Koichi
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Ohgi Kazuyuki
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Kimura Koichiro
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan Department of Diagnostic Radiology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
  • Ishitaki Koichi
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan Department of Diagnostic Radiology, Shin-Yurigaoka General Hospital, Kanagawa, Kawasaki, Japan
  • Yamashita Akiyoshi
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Yokote Hiroyuki
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Tsukuda Shunji
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Matsushita Ko
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Naraoka Yuko
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Fujioka Amon
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan
  • Ono Tatsuki
    Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan

Abstract

<p>Purpose: The kidney iron deposition can cause kidney damage and renal insufficiency in paroxysmal nocturnal hemoglobinuria (PNH) patients. Assessment of iron deposition in the kidney is essential for the early diagnosis of renal damage in PNH patients. The purpose of this study was to evaluate kidney R2* (T2* reciprocals) values in PNH patients using the iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ).</p><p>Methods: Two radiologists measured the R2* values of the renal cortex in 14 PNH patients and 13 healthy volunteers using IDEAL-IQ. Lactate dehydrogenase (LDH), a reliable marker of intravascular hemolysis, was also measured in all participants.</p><p>Results: The kidney R2* values were significantly higher in PNH patients compared with those in healthy volunteers (P < 0.001). High inter-operator reproducibility of the measurements was also acquired using IDEAL-IQ. LDH levels were also significantly higher in PNH patients compared with those in healthy volunteers (P < 0.001). Kidney R2* values strongly correlated with LDH levels in PNH patients.</p><p>Conclusion: IDEAL-IQ has a possibility of becoming a useful method for the noninvasive evaluation of renal iron overload in PNH patients.</p>

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