This study compared clinical decision making between FerriScan and an R2*-based method in patients with iron overload disease. FerriScan is the current gold standard. However, it is expensive, and data must be transferred offsite. FerriScan and R2* techniques were both used to manage (simulated) patient chelator dosing. The agreement between different reviewers assessing the same FerriScan data was the same as the agreement when the same reviewer used R2*- compared to FerriScan-derived LIC values. Thus, switching to R2*-based decision making from FerriScan is no more likely to cause a difference in patient management than switching from one hematologist to another.