TOPLINE:

Quantitative T2* MRI was feasible and reproducible for detecting iron in the soft tissues of the fingers, with healthy individuals having a mean T2* value of 14.0 milliseconds. Patients with digital microvasculopathy had lower mean T2* values, ranging from 5.2 to 14.3 milliseconds, suggesting excess iron deposition compared with that in control individuals.

METHODOLOGY:

• Researchers conducted a prospective cohort study, involving 10 healthy individuals aged 28-60 years (mean age, 34.6 years) and three patients with digital microvasculopathy confirmed using nailfold capillaroscopy.
• Participants underwent MRI of the hands using a 1.5T scanner to generate T2* parametric maps of finger soft tissues.
• Calibration was performed using agarose-based gel phantoms containing graded iron concentrations (0.095, 0.950, 1.800, and 2.600 mg/mL) to establish a system-specific calibration curve for quantifying iron in finger soft tissues.
• Multiple regions of interest were placed in soft tissue areas that showed increased susceptibility on dual-coloured T2* maps, with a radiologist recording the three lowest T2* values per finger for both hands.
• Four healthy individuals repeated the examination 1 year after the first MRI study to assess the reproducibility of T2* measurements in the fingers' soft tissues.

TAKEAWAY:

• Mean T2* values for healthy individuals ranged from 12.5 to 16.0 milliseconds (mean ± SD per individual, 14.0 ± 2.6 milliseconds), with a single outlier measurement of 8.8 milliseconds, establishing a lower limit of normal at 8.8 milliseconds for soft tissues of the fingers.
• Patients with digital microvasculopathy had mean T2* values per finger (excluding the thumb) of 7.4 milliseconds (range, 5.2-8.8 milliseconds), 7.9 milliseconds (range, 5.9-10.3 milliseconds), and 7.9 milliseconds (range, 5.7-14.3 milliseconds); the mean across patients was lower than that across control individuals (7.7 vs 13.8 milliseconds).
• In healthy individuals, the thumbs of both hands had higher mean T2* values (15.6 milliseconds) than the other fingers (13.6 milliseconds; P < .001).
• Follow-up after 1 year showed no areas with T2* values below 8.8 milliseconds in the four healthy individuals, demonstrating reproducibility and stability of T2* measurements in soft tissues of the fingers over time.

IN PRACTICE:

"GRE [gradient echo] T2* MRI provides a rapid, noninvasive, reproducible means for assessing iron deposition in the soft tissues of the hands. All calculated T2*-based MR [magnetic resonance] relaxometry parameters showed statistically significant differences between the fingers of patients and those of healthy subjects, allowing us to define a cut-off value of 8.8 ms [milliseconds] for normal. Although these preliminary findings need validation in larger studies, they highlight the potential application of quantitative ΜRI relaxometry techniques for evaluating iron deposition in the hands of patients suffering from SSc [systemic sclerosis] and other vasculopathies with microbleeds in the fingers, possibly providing information on the role of tissue iron deposition in the pathophysiology of the disease," the authors wrote.

SOURCE:

The study was led by Artemis Galani, National and Kapodistrian University of Athens, Athens, Greece. It was published online on May 20, 2026, in NMR in Biomedicine.

LIMITATIONS:

The study was limited by the small sample size of 10 healthy individuals and three patients, the lack of soft-tissue biopsies for validation, susceptibility artifacts at air-soft tissue interfaces, the field-strength specificity of the 8.8-millisecond T2* threshold to 1.5T scanners, the machine- and sequence-dependence of relaxation parameters, and the inability to make an exact comparison with non-quantitative nailfold capillaroscopy.

DISCLOSURES:

One author reported receiving a research grant from the Foundation for Research in Rheumatology and a postdoctoral fellowship from the Bodossaki Foundation. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.