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Therapeutic options for iron chelation therapy have increased and many patients now receive combination therapies. However, optimal utilization of iron chelation therapy requires knowledge not only of the total body iron burden but the relative iron distribution among the different organs. The physiological basis for extrahepatic iron deposition is presented in order to help identify patients at highest risk for cardiac and endocrine complications. This manuscript reviews the current state of the art for monitoring global iron overload status as well as its compartmentalization. Plasma markers, computerized tomography, liver biopsy, magnetic susceptibility devices and magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) techniques are all discussed but <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> has come to dominate clinical practice. The potential impact of recent pancreatic and pituitary <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> studies on clinical practice are discussed as well as other works\u2010in\u2010progress. Clinical protocols are derived from experience in haemoglobinopathies but may provide useful guiding principles for other iron overload disorders, such as myelodysplastic syndromes.<\/jats:p>","DOI":"10.1111\/bjh.13374","type":"journal-article","created":{"date-parts":[[2015,3,12]],"date-time":"2015-03-12T21:32:11Z","timestamp":1426195931000},"page":"15-28","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":116,"title":["Estimating tissue iron burden: current status and future prospects"],"prefix":"10.1111","volume":"170","author":[{"given":"John C.","family":"Wood","sequence":"first","affiliation":[{"name":"Division of Cardiology Children's Hospital Los Angeles Los Angeles CA 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