Pub Date : 2024-05-21DOI: 10.1186/s43066-024-00336-5
U. Maimunah, Puspa Wardhani, C. Wungu, Anisa Firdausi Rahmanda, Andreas Agung Kurniawan, Andrio Palayukan
{"title":"Correlation between quantitative HBsAg and quantitative HBV DNA in chronic hepatitis B patients: a systematic review and meta-analysis","authors":"U. Maimunah, Puspa Wardhani, C. Wungu, Anisa Firdausi Rahmanda, Andreas Agung Kurniawan, Andrio Palayukan","doi":"10.1186/s43066-024-00336-5","DOIUrl":"https://doi.org/10.1186/s43066-024-00336-5","url":null,"abstract":"","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141113828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1186/s43066-024-00338-3
Mohamed Hassany, Ahmed Mostafa Mahboub, Wessam Mostafa, Hossam Debian, Hend Ibrahim Shousha, Magdy El-Serafy
Radiofrequency ablation (RFA) and microwave ablation (MWA) are widely accepted as the established treatment options for patients diagnosed with early-stage hepatocellular carcinoma (HCC) who are deemed unfit for surgical procedures. However, the effective implementation of these techniques is hindered by various challenges, primarily associated with the precise targeting of tumors within the liver. The utilization of thermal ablative methods is not recommended for hepatocellular carcinoma (HCC) that is located near intestinal loops, bile ducts, or in eccentric positions. The unmet need for non-thermal methods in the treatment of hepatocellular carcinoma (HCC) was addressed following the introduction of irreversible electroporation (IRE) as an innovative approach. To assess the efficacy, safety, and outcomes of IRE in the treatment of difficult-located HCC compared to transarterial chemoembolization (TACE). This is a prospective study that included 24 patients with HCC who presented to the National Hepatology and Tropical Medicine Research Institute (NHTMRI) during the period from January 2017 to January 2020. Ten patients underwent IRE, while 14 patients underwent TACE. Sixteen patients (66.7%) were males; eight patients were females (33.3%). Their median age was 60.5 years (48–70 years). Seventeen patients (70.8%) were Child–Pugh class A, while seven patients (29.2%) were Child–Pugh class B. All the study population had a single focal lesion; the mean size of the focal lesions was 2.94 ± 0.59 cm. The most frequent difficult locations of HCC were segment V focal lesions adjacent to both the common bile duct and portal vein in eight patients (33.3%) followed by lesions adjacent to the inferior vena cava in five patients (20%) followed by the subcapsular lesions in three patients (12.5%) and lesions adjacent to the right kidney in two patients (8.3%). Complete response (CR) was higher in the IRE group (80%) compared to the TACE group (50%). Clinical decompensation occurred in six patients in the IRE group (60%) and eight patients in the TACE group (57.1%) (P value 1). Recurrence occurred in five patients (50%) treated with IRE and in seven patients (50%) treated with TACE (P value 1). Within the IRE group, two patients (20%) remained alive; on the other hand, within the TACE group six patients (42.9%) remained alive by the end of the study (P value 0.388). Our data suggest that IRE is an effective procedure in the treatment of difficult-located HCC in terms of complete response, fewer sessions, and fewer side effects as compared to TACE.
{"title":"Assessment of efficacy and safety of irreversible electroporation versus TACE for treatment of difficult location hepatocellular carcinoma","authors":"Mohamed Hassany, Ahmed Mostafa Mahboub, Wessam Mostafa, Hossam Debian, Hend Ibrahim Shousha, Magdy El-Serafy","doi":"10.1186/s43066-024-00338-3","DOIUrl":"https://doi.org/10.1186/s43066-024-00338-3","url":null,"abstract":"Radiofrequency ablation (RFA) and microwave ablation (MWA) are widely accepted as the established treatment options for patients diagnosed with early-stage hepatocellular carcinoma (HCC) who are deemed unfit for surgical procedures. However, the effective implementation of these techniques is hindered by various challenges, primarily associated with the precise targeting of tumors within the liver. The utilization of thermal ablative methods is not recommended for hepatocellular carcinoma (HCC) that is located near intestinal loops, bile ducts, or in eccentric positions. The unmet need for non-thermal methods in the treatment of hepatocellular carcinoma (HCC) was addressed following the introduction of irreversible electroporation (IRE) as an innovative approach. To assess the efficacy, safety, and outcomes of IRE in the treatment of difficult-located HCC compared to transarterial chemoembolization (TACE). This is a prospective study that included 24 patients with HCC who presented to the National Hepatology and Tropical Medicine Research Institute (NHTMRI) during the period from January 2017 to January 2020. Ten patients underwent IRE, while 14 patients underwent TACE. Sixteen patients (66.7%) were males; eight patients were females (33.3%). Their median age was 60.5 years (48–70 years). Seventeen patients (70.8%) were Child–Pugh class A, while seven patients (29.2%) were Child–Pugh class B. All the study population had a single focal lesion; the mean size of the focal lesions was 2.94 ± 0.59 cm. The most frequent difficult locations of HCC were segment V focal lesions adjacent to both the common bile duct and portal vein in eight patients (33.3%) followed by lesions adjacent to the inferior vena cava in five patients (20%) followed by the subcapsular lesions in three patients (12.5%) and lesions adjacent to the right kidney in two patients (8.3%). Complete response (CR) was higher in the IRE group (80%) compared to the TACE group (50%). Clinical decompensation occurred in six patients in the IRE group (60%) and eight patients in the TACE group (57.1%) (P value 1). Recurrence occurred in five patients (50%) treated with IRE and in seven patients (50%) treated with TACE (P value 1). Within the IRE group, two patients (20%) remained alive; on the other hand, within the TACE group six patients (42.9%) remained alive by the end of the study (P value 0.388). Our data suggest that IRE is an effective procedure in the treatment of difficult-located HCC in terms of complete response, fewer sessions, and fewer side effects as compared to TACE.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140885291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.1186/s43066-024-00340-9
Maged Tharwat Elghannam, Moataz Hassan Hassanien, Yosry Abdelrahman Ameen, Emad Abdelwahab Turky, Gamal Mohammed ELattar, Ahmed Aly ELRay, Mohammed Darwish ELTalkawy
Mouth is the gateway to the total body wellness. Accordingly, oral microbiome influences overall health of an individual. Oral microbiome plays a key role in shaping up the host’s health profile. Obvious differences have been reported between patients with gastrointestinal diseases and healthy controls. The oral and gut microbiome profiles are well-segregated due to the oral–gut barrier. However, the oral microbiota can translocate to the intestinal mucosa in conditions of the oral–gut barrier dysfunction. Oral bacteria can disseminate to the distal gut via enteral or hematogenous routes. The translocation of oral microbes to the gut may give rise to a variety of gastrointestinal diseases including Helicobacter-induced diseases, irritable bowel syndrome, inflammatory bowel disease, celiac disease, and colorectal cancer. Understanding the role of the oral-to-gut microbial translocation in the pathogenesis will contribute to precise diagnosis and effective treatment. In this review, we aim to highlight the role of oral microbiota dysfunction in various gastrointestinal disorders.
{"title":"Oral microbiome dysbiosis and gastrointestinal diseases: a narrative review","authors":"Maged Tharwat Elghannam, Moataz Hassan Hassanien, Yosry Abdelrahman Ameen, Emad Abdelwahab Turky, Gamal Mohammed ELattar, Ahmed Aly ELRay, Mohammed Darwish ELTalkawy","doi":"10.1186/s43066-024-00340-9","DOIUrl":"https://doi.org/10.1186/s43066-024-00340-9","url":null,"abstract":"Mouth is the gateway to the total body wellness. Accordingly, oral microbiome influences overall health of an individual. Oral microbiome plays a key role in shaping up the host’s health profile. Obvious differences have been reported between patients with gastrointestinal diseases and healthy controls. The oral and gut microbiome profiles are well-segregated due to the oral–gut barrier. However, the oral microbiota can translocate to the intestinal mucosa in conditions of the oral–gut barrier dysfunction. Oral bacteria can disseminate to the distal gut via enteral or hematogenous routes. The translocation of oral microbes to the gut may give rise to a variety of gastrointestinal diseases including Helicobacter-induced diseases, irritable bowel syndrome, inflammatory bowel disease, celiac disease, and colorectal cancer. Understanding the role of the oral-to-gut microbial translocation in the pathogenesis will contribute to precise diagnosis and effective treatment. In this review, we aim to highlight the role of oral microbiota dysfunction in various gastrointestinal disorders.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140885239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-04DOI: 10.1186/s43066-024-00339-2
Mohamed El-Kassas, Reem El Sheemy, Mohamed Elbadry
Schistosomiasis is an old parasitic disease in Egypt primarily caused by Schistosoma mansoni, transmitted through infected water canals, and disproportionately affects rural areas. Despite substantial reductions in the disease prevalence over the years, it still affects more than 5% of the population in some governorates, highlighting the need for sustained control efforts. Among the recent control measures: (a) mass drug administration with large-scale, biannual administration of praziquantel, which remains the cornerstone of the control program targeting the interruption of vector transmission cycles. (b) Improving disease diagnostics, including point-of-care tests, which facilitate early detection and case management, particularly in remote areas. (c) Snail control using targeted mollusciciding aims to reduce parasite transmission by controlling intermediate snail hosts. And (d) behavioral change communication focusing on raising awareness regarding hygiene practices and safe water access. Even if control attempts have shown positive results, several challenges still exist, including (a) drug resistance, especially to praziquantel, the most commonly used drug, which calls for ongoing observation and monitoring. (b) Sustainability of funding to avoid program disruptions and setbacks. And (c) social and environmental factors like poverty, poor sanitation, and access to clean water. The transition from disease control to elimination requires meticulous planning and vigilance. Robust surveillance systems, enhanced case management, and continued community engagement are vital for such elimination. Strengthening research on drug resistance, snail control methods, and innovative diagnostics would further support elimination efforts. This report aims to address the most recent data regarding the prevalence and control measures for schistosomiasis in Egypt and provide the information required to lead the transition from disease control to elimination.
{"title":"Strategies and achievements in controlling and eliminating schistosomiasis from Egypt","authors":"Mohamed El-Kassas, Reem El Sheemy, Mohamed Elbadry","doi":"10.1186/s43066-024-00339-2","DOIUrl":"https://doi.org/10.1186/s43066-024-00339-2","url":null,"abstract":"Schistosomiasis is an old parasitic disease in Egypt primarily caused by Schistosoma mansoni, transmitted through infected water canals, and disproportionately affects rural areas. Despite substantial reductions in the disease prevalence over the years, it still affects more than 5% of the population in some governorates, highlighting the need for sustained control efforts. Among the recent control measures: (a) mass drug administration with large-scale, biannual administration of praziquantel, which remains the cornerstone of the control program targeting the interruption of vector transmission cycles. (b) Improving disease diagnostics, including point-of-care tests, which facilitate early detection and case management, particularly in remote areas. (c) Snail control using targeted mollusciciding aims to reduce parasite transmission by controlling intermediate snail hosts. And (d) behavioral change communication focusing on raising awareness regarding hygiene practices and safe water access. Even if control attempts have shown positive results, several challenges still exist, including (a) drug resistance, especially to praziquantel, the most commonly used drug, which calls for ongoing observation and monitoring. (b) Sustainability of funding to avoid program disruptions and setbacks. And (c) social and environmental factors like poverty, poor sanitation, and access to clean water. The transition from disease control to elimination requires meticulous planning and vigilance. Robust surveillance systems, enhanced case management, and continued community engagement are vital for such elimination. Strengthening research on drug resistance, snail control methods, and innovative diagnostics would further support elimination efforts. This report aims to address the most recent data regarding the prevalence and control measures for schistosomiasis in Egypt and provide the information required to lead the transition from disease control to elimination.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-03DOI: 10.1186/s43066-024-00337-4
Eman Mahmoud Barakat, Iman Fawzy Montasser, Doaa Zakaria Zaky, Yasser Arafat Abdelrazik, Hoda Mohammed Farid, Ahmed El Dorry, Mohammed Kamal Shaker
Globally, MAFLD becomes in the top list of causes of liver disease. Its effect ranges from steatosis, metabolic steato-hepatitis to MAFLD-related cirrhosis and hepatocellular carcinoma. There is a growing evidence that MAFLD-related HCC seems to be different from HCCs of other causes pathologically, so the purpose of our study was to assess the effect of MAFLD on the prognosis of HCC regarding outcome after management of HCC and survival rate in comparison to a group of patients with HCV-related HCC. Twenty-nine patients with MAFLD related HCC were included in group A, while 58 patients with HCV related HCC were enrolled as group B. Both groups were matched regarding age and gender. The mean age in group A and B was 58.86 (±8.47) years and 60/05(± 6.83) years respectively. Comparison between both groups regarding tumor burden and characteristics of HCC, type of management, and post intervention follow-up showed no significant statistical difference between both groups except for lymph node metastases which was higher in patients with HCV related HCC with p = 0.045. Also, a significant difference between both studied groups regarding AFP was detected; the median of AFP in MAFLD-related HCC was (7.2 ng/ml) but much higher in HCV-related HCC group (129.2 ng/ml) with p = 0.001. Our data showed no significant difference between the two studied groups regarding outcome of HCC or survival rate except for AFP level before and after management which was higher in HCV patients related HCC. Although both of inclusion and exclusion criteria were strict to the criteria, so the number of participants in the research were not large enough; to our knowledge, this is the first study on MAFLD-HCC in Egypt and Africa. More studies on prospective bases are essentially needed to stand on solid conclusion about the nature and outcome of MAFLD-related HCC.
{"title":"Outcome of MAFLD-related HCC in Egyptian patients: a single center study","authors":"Eman Mahmoud Barakat, Iman Fawzy Montasser, Doaa Zakaria Zaky, Yasser Arafat Abdelrazik, Hoda Mohammed Farid, Ahmed El Dorry, Mohammed Kamal Shaker","doi":"10.1186/s43066-024-00337-4","DOIUrl":"https://doi.org/10.1186/s43066-024-00337-4","url":null,"abstract":"Globally, MAFLD becomes in the top list of causes of liver disease. Its effect ranges from steatosis, metabolic steato-hepatitis to MAFLD-related cirrhosis and hepatocellular carcinoma. There is a growing evidence that MAFLD-related HCC seems to be different from HCCs of other causes pathologically, so the purpose of our study was to assess the effect of MAFLD on the prognosis of HCC regarding outcome after management of HCC and survival rate in comparison to a group of patients with HCV-related HCC. Twenty-nine patients with MAFLD related HCC were included in group A, while 58 patients with HCV related HCC were enrolled as group B. Both groups were matched regarding age and gender. The mean age in group A and B was 58.86 (±8.47) years and 60/05(± 6.83) years respectively. Comparison between both groups regarding tumor burden and characteristics of HCC, type of management, and post intervention follow-up showed no significant statistical difference between both groups except for lymph node metastases which was higher in patients with HCV related HCC with p = 0.045. Also, a significant difference between both studied groups regarding AFP was detected; the median of AFP in MAFLD-related HCC was (7.2 ng/ml) but much higher in HCV-related HCC group (129.2 ng/ml) with p = 0.001. Our data showed no significant difference between the two studied groups regarding outcome of HCC or survival rate except for AFP level before and after management which was higher in HCV patients related HCC. Although both of inclusion and exclusion criteria were strict to the criteria, so the number of participants in the research were not large enough; to our knowledge, this is the first study on MAFLD-HCC in Egypt and Africa. More studies on prospective bases are essentially needed to stand on solid conclusion about the nature and outcome of MAFLD-related HCC.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29DOI: 10.1186/s43066-024-00334-7
ŞH Aktaş, S. Basat
Osler-Weber-Rendu syndrome (OWRS) is an autosomal dominant disease with recurrent epistaxis, mucocutaneous telangiectasias, and arteriovenous malformations. Its clinical presentation ranges from simple skin lesions to life-threatening complications. When the diagnosis of the disease is delayed, it can be mortal and have high morbidity. This case is presented because OWRS is rare, and although she has all the features of the disease, she was diagnosed in the geriatric age group. A 72-year-old female patient who applied to the emergency department with the complaint of melena was diagnosed with upper gastrointestinal system bleeding. Gastroscopy revealed angiodysplasia in the bulb. Colonoscopy was normal. She had telangiectasias on her face, maxilla, nose, tongue and lips. She also had recurrent epistaxis and a family history. Thorax CT showed aneurysmatic vascular malformations in the lung. Abdominal MRI revealed vascular malformations in the liver. Brain MRI was normal. The patient was diagnosed with OWRS according to the Curaçao diagnostic criteria because of telangiectasia in the mouth, nose, and face, angiodysplasia in the gastric bulb, aneurysmatic vascular dilatation in the lung, vascular pathologies in the liver, and a history of epistaxis and telangiectasia in the patient’s family members. This patient is presented because OWRS is rare, and although she has all the features of the disease, she was diagnosed in the geriatric age group. Clinicians should be aware of this rare disease. Especially in the elderly, when angiodysplasia causing gastrointestinal bleeding is detected, it should be considered in the differential diagnosis that this may be an OWSR case.
{"title":"A case of Osler-Weber-Rendu syndrome, diagnosed at geriatric age, presenting with gastrointestinal bleeding, telangiectasias, and asymptomatic liver and lung angiodysplasia","authors":"ŞH Aktaş, S. Basat","doi":"10.1186/s43066-024-00334-7","DOIUrl":"https://doi.org/10.1186/s43066-024-00334-7","url":null,"abstract":"Osler-Weber-Rendu syndrome (OWRS) is an autosomal dominant disease with recurrent epistaxis, mucocutaneous telangiectasias, and arteriovenous malformations. Its clinical presentation ranges from simple skin lesions to life-threatening complications. When the diagnosis of the disease is delayed, it can be mortal and have high morbidity. This case is presented because OWRS is rare, and although she has all the features of the disease, she was diagnosed in the geriatric age group. A 72-year-old female patient who applied to the emergency department with the complaint of melena was diagnosed with upper gastrointestinal system bleeding. Gastroscopy revealed angiodysplasia in the bulb. Colonoscopy was normal. She had telangiectasias on her face, maxilla, nose, tongue and lips. She also had recurrent epistaxis and a family history. Thorax CT showed aneurysmatic vascular malformations in the lung. Abdominal MRI revealed vascular malformations in the liver. Brain MRI was normal. The patient was diagnosed with OWRS according to the Curaçao diagnostic criteria because of telangiectasia in the mouth, nose, and face, angiodysplasia in the gastric bulb, aneurysmatic vascular dilatation in the lung, vascular pathologies in the liver, and a history of epistaxis and telangiectasia in the patient’s family members. This patient is presented because OWRS is rare, and although she has all the features of the disease, she was diagnosed in the geriatric age group. Clinicians should be aware of this rare disease. Especially in the elderly, when angiodysplasia causing gastrointestinal bleeding is detected, it should be considered in the differential diagnosis that this may be an OWSR case.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140811868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.1186/s43066-024-00333-8
Ayush Agarwal, Arpit Shastri, C. P. Ganesh, Malvika Shastri, Suvradeep Mitra, Debadrita Ray, Arka De
{"title":"Cholestatic liver injury secondary to over-the-counter cyproheptadine: case report and review of literature","authors":"Ayush Agarwal, Arpit Shastri, C. P. Ganesh, Malvika Shastri, Suvradeep Mitra, Debadrita Ray, Arka De","doi":"10.1186/s43066-024-00333-8","DOIUrl":"https://doi.org/10.1186/s43066-024-00333-8","url":null,"abstract":"","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140662832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iron overload is a major problem in beta thalassemia patients due to repeated blood transfusions. The liver is the first organ to be loaded with iron. An accurate assessment of iron overload is necessary for managing iron chelation therapy in such patients. Iron quantification by MRI scores over liver biopsy due to its non-invasive nature. Fifty-one patients with thalassemia major were subjected to 3.0-T MRI. Multiecho T2* sequence was used to cover the entire liver. Region of interest (ROI) was placed in three areas with maximum signal change, and an average T2* value was obtained. Similarly, a single ROI was placed at the mid-interventricular septum in the heart, and T2* value was obtained. T2* values so obtained were converted to iron concentration with the help of a T2* iron concentration calculator. The liver iron values were correlated with serum ferritin value. There was a significant negative correlation between liver iron concentration (LIC) and T2* value of the liver (r = − 0.895, p < 0.01) and between cardiac iron concentration (CIC) and T2* value of the heart (r = − 0.959, p < 0.01). There was a slight positive correlation between LIC and serum ferritin (r = 0.642, p < 0.01) and no correlation between CIC and serum ferritin (r = − 0.137, p = 0.354). MRI is a useful tool to titrate the doses of chelating agents as it is accurate and non-invasive, does not involve radiation hazards and hence can be repeated as and when needed. Simultaneous assessment of cardiac iron overload is an added advantage of MRI.
{"title":"Role of magnetic resonance imaging (MRI) in liver iron quantification in thalassemic (thalassemia major) patients","authors":"Rohilla Seema, Chadha Kawaljeet Singh, Verma Anjali, Gill Paramjeet Singh, Yadav Alka, Singla Deepak","doi":"10.1186/s43066-024-00330-x","DOIUrl":"https://doi.org/10.1186/s43066-024-00330-x","url":null,"abstract":"Iron overload is a major problem in beta thalassemia patients due to repeated blood transfusions. The liver is the first organ to be loaded with iron. An accurate assessment of iron overload is necessary for managing iron chelation therapy in such patients. Iron quantification by MRI scores over liver biopsy due to its non-invasive nature. Fifty-one patients with thalassemia major were subjected to 3.0-T MRI. Multiecho T2* sequence was used to cover the entire liver. Region of interest (ROI) was placed in three areas with maximum signal change, and an average T2* value was obtained. Similarly, a single ROI was placed at the mid-interventricular septum in the heart, and T2* value was obtained. T2* values so obtained were converted to iron concentration with the help of a T2* iron concentration calculator. The liver iron values were correlated with serum ferritin value. There was a significant negative correlation between liver iron concentration (LIC) and T2* value of the liver (r = − 0.895, p < 0.01) and between cardiac iron concentration (CIC) and T2* value of the heart (r = − 0.959, p < 0.01). There was a slight positive correlation between LIC and serum ferritin (r = 0.642, p < 0.01) and no correlation between CIC and serum ferritin (r = − 0.137, p = 0.354). MRI is a useful tool to titrate the doses of chelating agents as it is accurate and non-invasive, does not involve radiation hazards and hence can be repeated as and when needed. Simultaneous assessment of cardiac iron overload is an added advantage of MRI.","PeriodicalId":11620,"journal":{"name":"Egyptian Liver Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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