FerriScan : Non-invasive measurement of liver iron concentration

Yes Sahil, the ejection fraction is an interpretation, so if the result is low it is advisable to have the echo done again to verify the result. Your T2* result is great!

Andy,

Do you know why Ferriscan is not typically done for smaller children?  Do you know how big a child should be before they can have Ferriscan?  My son is almost 27kg, we have considered taking him to NY for a Ferriscan but we are not sure when it would be a good time to do so. 

Thanks,
Sharmin

It's actually very simple why Ferriscan isn't used on young children. It requires them to lie still enclosed in an MRI machine for around 20 minutes, so it is not recommended. Also, it is unlikely to have high iron deposits before that age, especially if chelation has been used.

Thanks Andy, that makes sense. 

Sharmin

Andy,

Since we are being followed carefully with the SQUID and T2* right now we probably don't even need to consider Ferriscan at this time.  Do you think there is any value for us doing Ferriscan now?  My son has an incredible ability to stay still through anything, other than dinner...

He did not flinch during the 45 minute T2* or the SQUID. 

Thanks again,

Sharmin

Sharmin,

Wasn't his liver already checked by MRI?

Honestly. the main reason now for doing a Ferriscan would be to establish a current baseline, which can be used to compare to future measures. His intensive chelation should be cleaning his liver out well, so now the heart tests are necessary to see if any change in chelation strategy should or can be considered. Regular T2* tests can also assess the affect of Exjade.

Hi Andy,

His LIC was measured using the SQUID and T2* was used to look at his heart.  They did not find any elevated iron levels in his heart - which was a great relief.  As per the study, they are going to repeat all of these tests this winter (probably February) to evaluate how well the chelation is working.  I spoke with the Ferriscan people last spring, and I am wondering if it may be a good idea to get a baseline measure. 

His Exjade levels were increased this week and this is the fifth week since his last transfusion.  His iron levels may drop quite quickly now.  He is on 625mg of exjade and 12hrs/day 5 days a week desferal.  He gets about 534cc of blood every 4 to 5 weeks. 
One concern I have is that between now and February, his iron levels could drop quite drastically (which is great) but I wonder if his chelation should be reduced sooner than February. 

First of all sorry for asking such a foolish question 

How are the FerriScan reports like? Are they in ng/ml like the Serum Ferritin report?


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Hello everyone

I'm back from Singapore and the conference was great. It was a great pleasure to meet with many of you!

From the conference, we learnt that it is very important to manage your liver iron, especially for younger children where iron will start building in the liver before the heart. Dr Farrukh Shah from the UK gave a wonderful talk on FerriScan and how she uses FerriScan in her routine care for thalassemic patients.

Andy has done a great job here explaining how FerriScan works to all of you. To answer some of your questions and to provide more information on how FerriScan is used in the clinical setting:

1) FerriScan uses the R2 imaging technique not R2*. All these different R2, T2*, R2* are methods of MRI image (data) acquisition. 
2) FerriScan provides a LIC in mg/g dry weight. For example: A thalassemic patient with a FerriScan LIC in the range of 3.2 - 7.0 mg/g dry weight is considered good. If the FerriScan LIC is more than 15.0 mg/g dry weight. it will be considered high risk for cardiac disease. Click on this link to view the sensitivity and specificity chart. http://content.resonancehealth.com/000345.pdf
3) FerriScan report is usually returned to the MRI center after the analysis is done. The MRI center then forward the results to the referring clinician who will then discuss the LIC results with the patients.

Sharmin, which part of Canada are you from? The doctors in Toronto have been submitting patients application for MOH funded FerriScan. So far, doctors from The Sick Children Hospital and Toronto General Hospital have successfully helped patients to obtain funded FerriScan.

Attached is also a sample of the FerriScan LIC report. You can see from the report that it has a diagram showing how iron is distributed in the liver as well as providing a LIC reading.

Let me know if you need any more clarification.

Cheers,

Sylvia

Hi Sylvia,

It was very nice meeting you at the conference and I really enjoyed my talk with Tim.

When posting, right below the box it says additional options. Click this and more options appear. Browse for your file and add it to your post. It will then appear as an attachment to your post.

Thanks Andy. I modified my reply and insert the sample report attachment.

Doctors here have mentioned that 500 - 600 is the level of ferritin, at which Exjade should be re-introduced/started rather than waiting for your iron levels to go to 1000.  At that point maybe you can start on a very low dose of Exjade.  You can check with your doctor. 

I started off with Exjade when my S.Ferritin was 337 ng/ml. After a month it was 279 ng/ml. Then I got the T2* done. I mailed all of my reports to one of the best hematologist in Mumbai, Dr.M B Agarwal. He asked me to repeat my S.Ferritin every month and the day it reaches 1000 ng/ml start with Asunra (Exjade) again with 20mg/kg.

I spoke to two more doctors in Delhi, Dr. V K Khanna and Dr. V P Chaudhary, both of them said the same thing, to start Asunra when the S.Ferritin is 1000 ng/ml. Infact Dr. Khanna told me Exjade is not to be taken if the S.Ferritin level is below 500 ng/ml.

Its been 40 days I'm off chelation. I would be repeating my S.Ferritin, lets see what the results are.


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sgoh,

Thanks a lot for the example report!!


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Its been 40 days I'm off chelation. I would be repeating my S.Ferritin, lets see what the results are.

How blissful it must be to be off chelation,i wonder when i'd be able to do the same with my daughter.

Zaini.

How blissful it must be to be off chelation,i wonder when i'd be able to do the same with my daughter.

Zaini.

Don't worry Zaini, your daughters S.Ferritin will get normal soon. You just have to be regular with the chelation. No other way that you can get it down.

Wishing you Luck!! Take Care!!


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