{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:42:38Z","timestamp":1776339758942,"version":"3.51.2"},"reference-count":48,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Purpose: This study aimed to assess the utility of native T1 mapping for the evaluation of myocardial iron overload in patients with Thalassemia Major. T1 was compared to T2*, which represents the gold standard for iron quantification in the heart and liver. Methods: Consecutive patients with Thalassemia Major who performed cardiac MRI at the University Hospital of Sassari between 2022 and 2024 were prospectively included. All patients underwent a 1.5 T MRI with the same scanner (Philips Ingenia). T2* and native T1 mapping (MOLLI) sequences were performed in all patients on a mid-ventricular single 8 mm short-axis slice of the left ventricle. A region of interest was manually drawn in the septal wall. A T2* value &lt; 20 ms was considered indicative of significant myocardial iron overload. A normal lower limit value of 990 ms was adopted for native T1 mapping. Results: In total, 100 patients with Thalassemia Major were included (median age, 45 [range, 7\u201380] years; 55% were male). The median myocardial T2* value was 31.4 (range, 5.1\u201347) and median T1 was 941 ms (range, 557\u20131131). A total of 12 patients (12%) exhibited T2* values &lt; 20 ms; the T1 values in these patients (median, 733.8 ms [range, 557\u2013975]) were significantly lower compared to those with a T2* of 20 ms or greater (median, 961 ms [range, 820\u20131131]), p &lt; 0.001. No patient with T2* &lt; 20 ms had a T1 value greater than or equal to 990 ms. Among the 88 patients with T2* \u2265 20 ms, 56 (64%) had T1 &lt; 990 ms (median, 939.2 ms [range, 820\u2013986]). Using a T1 threshold of 990 ms, the sensitivity was 100%, but the specificity was only 36%. ROC analysis identified an optimal T1 value of 895.5 ms, corresponding to 92% sensitivity and 100% specificity. Conclusions: Native T1 mapping is highly sensitive for detecting myocardial iron overload in Thalassemia Major, but the standard 990 ms threshold generates many false-positive results. In our cohort, adopting an ROC-optimized threshold of 895.5 ms markedly improved specificity while preserving excellent sensitivity.<\/jats:p>","DOI":"10.3390\/tomography12040058","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T08:14:17Z","timestamp":1776154457000},"page":"58","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Utility of Native T1 Mapping for the Evaluation of Myocardial Iron Overload in Patients with Thalassemia Major"],"prefix":"10.3390","volume":"12","author":[{"given":"Antonio Matteo","family":"Amadu","sequence":"first","affiliation":[{"name":"Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio","family":"Contena","sequence":"additional","affiliation":[{"name":"Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0353-1360","authenticated-orcid":false,"given":"Alberto","family":"Dess\u00ec","sequence":"additional","affiliation":[{"name":"Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5487-1360","authenticated-orcid":false,"given":"Leandra","family":"Piscopo","sequence":"additional","affiliation":[{"name":"Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1981-7320","authenticated-orcid":false,"given":"Emma","family":"Solinas","sequence":"additional","affiliation":[{"name":"Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2063-994X","authenticated-orcid":false,"given":"Davide","family":"Turilli","sequence":"additional","affiliation":[{"name":"Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore Claudio","family":"Fanni","sequence":"additional","affiliation":[{"name":"Department of Translational Research, Academic Radiology, University of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0910-8064","authenticated-orcid":false,"given":"Mariano","family":"Scaglione","sequence":"additional","affiliation":[{"name":"Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Masala","sequence":"additional","affiliation":[{"name":"Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/S0140-6736(17)31822-6","article-title":"Thalassaemia","volume":"391","author":"Taher","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.hoc.2017.11.008","article-title":"The Evolving Spectrum of the Epidemiology of Thalassemia","volume":"32","author":"Weatherall","year":"2018","journal-title":"Hematol. Oncol. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.hoc.2017.11.006","article-title":"Clinical Classification, Screening and Diagnosis for Thalassemia","volume":"32","author":"Viprakasit","year":"2018","journal-title":"Hematol. Oncol. Clin. N. 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Imaging"}],"container-title":["Tomography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2379-139X\/12\/4\/58\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:44:21Z","timestamp":1776336261000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2379-139X\/12\/4\/58"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":48,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["tomography12040058"],"URL":"https:\/\/doi.org\/10.3390\/tomography12040058","relation":{},"ISSN":["2379-139X"],"issn-type":[{"value":"2379-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]}}}