AUTHOR=Luo Chaotian , Peng Fei , Xu Fengming , Tang Cheng , Zhang Yanyan , Huang Chaojie , Liang Linlin , Ning Xiaojing , Peng Peng 

TITLE=Assessing the accuracy of CMRtools software for diagnosing liver iron overload in thalassemia patients: influencing factors and optimisation strategies

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1424294

DOI=10.3389/fmed.2024.1424294

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Background</title><p>CMRtools is a software package that can be used to measure T2* values to diagnose liver iron overload, however, its accuracy in terms is affected by multiple factors, including goodness-of-fit (R<sup>2</sup> value), the number of echo time (TE) images, and the liver iron concentration (LIC). To investigate the effects of the R<sup>2</sup> value, the number of TE images, and the LIC on the accuracy of CMRtools software for measuring T2* values to diagnose liver iron overload (LIO).</p></sec><sec id="sec2"><title>Materials and methods</title><p>CMRtools software was used to measure liver T2* values among 108 thalassemia patients via the truncation method, and the R<sup>2</sup> values, the number of TE images, and T2* values were recorded. These values were subsequently converted into liver iron concentration (LIC<sub>T</sub>) values. The LIC<sub>F</sub> (derived from MRI-R2/FerriScan) was used as a reference, and the diagnostic accordance rate (DAR) was compared between R<sup>2</sup> value subgroups, between TE image number subgroups, and between LIC subgroups.</p></sec><sec id="sec3"><title>Results</title><p>The greater the R<sup>2</sup> value was, the greater the standardized DAR (SDAR) was (<italic>p</italic> &lt; 0.05). The SDAR are not identical between each TE image number subgroup (<italic>p</italic> &gt; 0.05). However, the relationship between TE image number subgroups and SDAR was analysed using Spearman’s correlation, and it was found to be positively correlated (<italic>r<sub>s</sub></italic> = 0.729, <italic>p</italic> = 0.017). The SDAR are not identical between each LIC subgroup (<italic>p</italic> &gt; 0.05), furthermore, the relationship between LIC subgroup and SDAR was found irrelevant (<italic>p</italic> = 0.747).</p></sec><sec id="sec4"><title>Conclusion</title><p>The accuracy of CMRtools software for diagnosing LIO in patients with thalassemia can be improved by artificially controlling the number of TE images to be fitted and selecting higher R<sup>2</sup> values.</p></sec>