{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:55:45Z","timestamp":1789552545975,"version":"build-2803163510"},"reference-count":38,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiol Bras"],"abstract":"<jats:p>Abstract  Objective: To review the recommended imaging modalities for pre-transplant evaluation in patients with sickle cell disease (SCD) undergoing allogeneic hematopoietic stem cell transplantation (HSCT).  Materials and Methods: This was a narrative review focusing on key imaging techniques employed to assess organ damage and stratify risks prior to HSCT in patients with SCD, including transcranial Doppler (TCD) ultrasonography, brain magnetic resonance imaging (MRI) with magnetic resonance angiography (MRA), MRI for osteonecrosis evaluation, and MRI-based hepatic iron quantification.  Results and discussion: TCD, including blind Doppler and TCD imaging (TCDI), plays a critical role in detecting in-creased cerebral blood flow velocities associated with stroke risk. Brain MRI\/MRA is essential for identifying silent cerebral infarcts and intracranial vasculopathy, even in patients with normal TCDI velocities. Bone MRI allows early detection of osteonecrosis, which is frequently asymptomatic in SCD. Liver MRI, using R2 relaxometry and T2*-weighting, provides accurate quantification of hepatic iron overload, an important risk factor for transplant-related complications. Cardiac MRI, chest computed tomography, and liver ultrasound are also recommended to help stratify pre-HSCT risk and identify organ damage.  Conclusion: A structured imaging protocol is essential for pre-HSCT assessment in SCD. Radiologists play a pivotal role in identifying subclinical organ damage and providing information critical to transplant candidacy and perioperative management.<\/jats:p>","DOI":"10.1590\/0100-3984.2025.0090","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:45:39Z","timestamp":1780310739000},"source":"Crossref","is-referenced-by-count":1,"title":["Pre-transplant imaging evaluation in sickle cell disease: recommended protocols before allogeneic hematopoietic stem cell transplantation"],"prefix":"10.1590","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3031-0459","authenticated-orcid":false,"given":"Fernando da Silva","family":"Xavier","sequence":"first","affiliation":[{"name":"United Health Group,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9882-3456","authenticated-orcid":false,"given":"Mayara Oliveira da","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2057-4469","authenticated-orcid":false,"given":"Lu\u00eds Henrique Dellabianca","family":"Pereira","sequence":"additional","affiliation":[{"name":"United Health Group,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4578-9423","authenticated-orcid":false,"given":"Adriana","family":"Seber","sequence":"additional","affiliation":[{"name":"United Health Group,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7874-9332","authenticated-orcid":false,"given":"M\u00e1rcio Lu\u00eds","family":"Duarte","sequence":"additional","affiliation":[{"name":"Universidade de Ribeir\u00e3o Preto Campus Guaruj\u00e1,  Brazil; Diagn\u00f3sticos da Am\u00e9rica S.A.,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1146\/annurev-pathmechdis-012418-012838","article-title":"Pathophysiology of sickle cell disease","volume":"14","author":"Sundd P","year":"2019","journal-title":"Annu Rev Pathol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"18010","DOI":"10.1038\/nrdp.2018.10","article-title":"Sickle cell disease","volume":"4","author":"Kato GJ","year":"2018","journal-title":"Nat Rev Dis Primers"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/jcm8101565","article-title":"Allogeneic hematopoietic stem cell transplantation for adults with sickle cell disease","volume":"8","author":"Saraf SL","year":"2019","journal-title":"J Clin Med"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"8841191","DOI":"10.1155\/2020\/8841191","article-title":"Quantification and comprehensive analysis of mesenchymal stromal cells in bone marrow samples from sickle cell disease patients with osteonecrosis","volume":"2020","author":"Ribeiro TO","year":"2020","journal-title":"Stem Cells Int"},{"issue":"2","key":"ref5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s10741-018-9670-7","article-title":"Transplantation in patients with iron overload: is there a place for magnetic resonance imaging?","volume":"23","author":"Mavrogeni S","year":"2018","journal-title":"Heart Fail Rev"},{"issue":"2","key":"ref6","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1002\/pbc.25306","article-title":"Implementation of transcranial Doppler ultrasonography screening and primary stroke prevention in urban and rural sickle cell disease populations","volume":"62","author":"Hussain S","year":"2015","journal-title":"Pediatr Blood Cancer"},{"issue":"5","key":"ref7","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1002\/ana.10192","article-title":"Sickle cell disease: the neurological complications","volume":"51","author":"Prengler M","year":"2002","journal-title":"Ann Neurol"},{"issue":"7","key":"ref8","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.bbmt.2017.03.020","article-title":"Allogeneic hematopoietic stem cell transplantation is underutilized in older patients with myelodysplastic syndromes","volume":"23","author":"Getta BM","year":"2017","journal-title":"Biol Blood Marrow Transplant"},{"issue":"6","key":"ref9","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1002\/ajh.21408","article-title":"The cost of health care for children and adults with sickle cell disease","volume":"84","author":"Kauf TL","year":"2009","journal-title":"Am J Hematol"},{"issue":"5","key":"ref10","doi-asserted-by":"crossref","first-page":"811","DOI":"10.3324\/haematol.2013.099747","article-title":"Hematopoietic stem cell trans-plantation in thalassemia major and sickle cell disease: indications and management recommendations from an international expert panel","volume":"99","author":"Angelucci E","year":"2014","journal-title":"Haematologica"},{"issue":"2","key":"ref11","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1002\/pbc.24177","article-title":"Allogeneic hematopoietic stem cell trans-plantation in children with sickle cell disease","volume":"59","author":"Locatelli F","year":"2012","journal-title":"Pediatr Blood Cancer"},{"issue":"4","key":"ref12","doi-asserted-by":"crossref","first-page":"e28172","DOI":"10.1002\/pbc.28172","article-title":"Practice patterns for stroke prevention using transcranial Doppler in sickle cell anemia: DISPLACE Consortium","volume":"67","author":"Schlenz AM","year":"2020","journal-title":"Pediatr Blood Cancer"},{"issue":"7","key":"ref13","doi-asserted-by":"crossref","first-page":"2822","DOI":"10.1182\/blood-2003-06-1972","article-title":"Magnetic resonance angiography in children with sickle cell disease and abnormal transcranial Doppler ultrasonography findings enrolled in the STOP study","volume":"103","author":"Abboud MR","year":"2004","journal-title":"Blood"},{"issue":"26","key":"ref14","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1056\/NEJMoa050460","article-title":"Discontinuing prophylactic transfusions used to prevent stroke in sickle cell disease","volume":"353","author":"Adams RJ","year":"2005","journal-title":"N Engl J Med"},{"issue":"5","key":"ref15","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/bjh.13477","article-title":"How I manage cerebral vasculopathy in children with sickle cell disease","volume":"170","author":"Brousse V","year":"2015","journal-title":"Br J Haematol"},{"issue":"21","key":"ref16","doi-asserted-by":"crossref","first-page":"4085","DOI":"10.1182\/blood.V124.21.4085.4085","article-title":"Magnetic resonance imaging\/angiography findings in adult patients with sickle cell disease: correlation with transcranial color Doppler sonography","volume":"124","author":"Graziadei G","year":"2014","journal-title":"Blood"},{"issue":"6","key":"ref17","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1001\/archneur.1993.00540060059019","article-title":"Abnormal cranial magnetic resonance imaging scans in sickle-cell disease: neurological correlates and clinical implica-tions","volume":"50","author":"Kugler S","year":"1993","journal-title":"Arch Neurol"},{"issue":"7","key":"ref18","doi-asserted-by":"crossref","first-page":"2822","DOI":"10.1182\/blood-2003-06-1972","article-title":"Magnetic resonance angiography in children with sickle cell disease and abnormal transcranial Doppler ultrasonography findings enrolled in the STOP study","volume":"103","author":"Abboud MR","year":"2004","journal-title":"Blood"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"32","DOI":"10.2174\/1874325000903010032","article-title":"Multifocal joint osteonecrosis in sickle cell disease","volume":"3","author":"Flouzat-Lachaniete CH","year":"2009","journal-title":"Open Orthop J"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jot.2019.12.004","article-title":"Guide-lines for clinical diagnosis and treatment of osteonecrosis of the femoral head in adults (2019 version)","volume":"21","author":"Zhao D","year":"2020","journal-title":"J Orthop Translat"},{"issue":"2","key":"ref21","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3109\/08880010903360367","article-title":"Design of the silent cerebral infarct transfusion (SIT) trial","volume":"27","author":"Casella JF","year":"2010","journal-title":"Pediatr Hematol Oncol"},{"issue":"6","key":"ref22","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1182\/blood-2013-12-545186","article-title":"Magnetic resonance imaging\/angiography and transcranial Doppler velocities in sickle cell anemia: results from the SWiTCH trial","volume":"124","author":"Helton KJ","year":"2014","journal-title":"Blood"},{"issue":"2","key":"ref23","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1002\/ajh.23604","article-title":"Parent education and biologic factors influence cognition in sickle cell anemia","volume":"89","author":"King AA","year":"2014","journal-title":"Am J Hematol"},{"issue":"7","key":"ref24","doi-asserted-by":"crossref","first-page":"104864","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.104864","article-title":"The role of MRA in pediatric sickle cell disease with normal transcranial Doppler imaging velocities","volume":"29","author":"Alshehri E","year":"2020","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"6","key":"ref25","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/s10554-006-9203-7","article-title":"Myocardial and hepatic T2* magnetic resonance evaluation in exthalassemic patients after bone-marrow transplan-tation","volume":"23","author":"Mavrogeni S","year":"2007","journal-title":"Int J Cardiovasc Imaging"},{"issue":"3","key":"ref26","doi-asserted-by":"crossref","first-page":"364","DOI":"10.3324\/haematol.2009.017244","article-title":"Iron overload in hematologic malignancies and outcome of allogeneic hematopoietic stem cell transplantation","volume":"95","author":"Koreth J","year":"2010","journal-title":"Haematologica"},{"issue":"2","key":"ref27","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1148\/radiol.2016152846","article-title":"Hepatic gadolinium deposition and reversibility after contrast agent-enhanced MR imaging of pediatric hematopoietic stem cell transplant recipients","volume":"281","author":"Maximova N","year":"2016","journal-title":"Radiology"},{"issue":"5","key":"ref28","first-page":"385","article-title":"Evaluation of myocardial iron overload using cardiovascular magnetic resonance imaging","volume":"52","author":"Mavrogeni S","year":"2011","journal-title":"Hellenic J Cardiol"},{"issue":"12","key":"ref29","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1038\/bmt.2009.88","article-title":"Effect of iron overload and iron-chelating therapy on allogeneic hematopoietic SCT in children","volume":"44","author":"Lee JW","year":"2009","journal-title":"Bone Marrow Transplantation"},{"issue":"4","key":"ref30","doi-asserted-by":"crossref","first-page":"e30013","DOI":"10.1002\/pbc.30013","article-title":"Imaging of pediatric hematopoietic stem cell transplant recipients: A COG Diagnostic Imaging Committee\/SPR Oncology Committee White Paper","volume":"70","author":"Chan SS","year":"2023","journal-title":"Pediatr Blood Cancer"},{"issue":"8884","key":"ref31","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/0140-6736(93)92753-G","article-title":"Fate of iron stores in thalassaemia after bone-marrow transplantation","volume":"342","author":"Lucarelli G","year":"1993","journal-title":"Lancet"},{"issue":"1","key":"ref32","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1002\/pbc.26213","article-title":"One-year results from a prospective randomized trial comparing phlebotomy with deferasirox for the treatment of iron overload in pediatric patients with thalassemia major following curative stem cell transplantation","volume":"64","author":"Inati A","year":"2017","journal-title":"Pediatr Blood Cancer"},{"issue":"4","key":"ref33","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1182\/blood.2023022500","article-title":"How I manage iron overload in the hematopoietic cell transplantation setting","volume":"145","author":"Angelucci E","year":"2025","journal-title":"Blood"},{"issue":"23","key":"ref34","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1053\/euhj.2001.2822","article-title":"Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload","volume":"22","author":"Anderson LJ","year":"2001","journal-title":"Eur Heart J"},{"issue":"2","key":"ref35","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s00277-022-05057-6","article-title":"Prognostic value of multiparametric cardiac magnetic resonance in sickle cell pa-tients","volume":"102","author":"Meloni A","year":"2023","journal-title":"Ann Hematol"},{"issue":"3","key":"ref36","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1038\/bmt.2016.309","article-title":"Pretransplant chest computed tomography screening in asymptomatic patients with leukemia and myelodysplastic syndrome","volume":"52","author":"El Boghdadly Z","year":"2017","journal-title":"Bone Marrow Transplant"},{"issue":"8","key":"ref37","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1038\/bmt.2009.349","article-title":"Hepatic veno-occlusive disease in children after hematopoietic stem cell transplantation: incidence, risk factors, and outcome","volume":"45","author":"Lee SH","year":"2010","journal-title":"Bone Marrow Transplant"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"4931","DOI":"10.2147\/IJGM.S419013","article-title":"Ultrasound Imaging in Subjects with Sickle Cell Disease: The Saudi Arabia Experiences","volume":"16","author":"Adam M","year":"2023","journal-title":"Int J Gen Med"}],"container-title":["Radiologia Brasileira"],"original-title":["Avalia\u00e7\u00e3o por imagem pr\u00e9-transplante na doen\u00e7a falciforme: protocolos recomendados antes do transplante alog\u00eanico de c\u00e9lulas-tronco hematopo\u00e9ticas"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0100-39842026000101005&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:45:44Z","timestamp":1780310744000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0100-39842026000101005&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":38,"alternative-id":["S0100-39842026000101005"],"URL":"https:\/\/doi.org\/10.1590\/0100-3984.2025.0090","relation":{},"ISSN":["1678-7099"],"issn-type":[{"value":"1678-7099","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20250090"}}