The role of diffusion‐weighted imaging in prediction liver iron concentration in beta‐thalassaemia patients

Objective The aim of this study was to analyse the value of diffusion‐weighted magnetic resonance imaging ( DWI ) to determine the liver parenchyma iron concentration in β‐thalassaemia major patients. Methods Abdominal magnetic resonance ( MR ) imaging, including gradient echo sequences and DWI sequences, was undertaken of 55 β‐thalassaemia major patients. The apparent diffusion coefficient ( ADC ) values of liver parenchyma were measured in seven regions at the level of the portal bifurcation and compared with liver iron concentration ( LIC ). Patients with normal and mild liver dry weight ( LDW ) results were classified as group 1, whereas patients with moderate and severe values were classified as group 2. Results There was a dramatic decrease in ADC values as the severity of LIC increased. The median ADC values were 1.6–1.9 × 10 −3  mm 2 /sec in group 1 and 0.6–0.9 × 10 −3  mm 2 /sec in group 2. A negative correlation was observed between ADC and the LDW values in both groups. The ADC and LIC correlation in each subgroup was statistically significant with asymptotic 95% confidence intervals of 0.820–0.997. Conclusion Diffusion‐weighted imaging is sensitive to tissue changes as a result of iron accumulation and may be used to predict liver iron overload in β‐thalassaemia major patients with a high sensitivity and specificity.