Erschienen in:
29.07.2015 | Magnetic Resonance
Prognostic significance of increased bone marrow microcirculation in newly diagnosed multiple myeloma: results of a prospective DCE-MRI study
verfasst von:
Maximilian Merz, Thomas M. Moehler, Judith Ritsch, Tobias Bäuerle, Christian M. Zechmann, Barbara Wagner, Anna Jauch, Dirk Hose, Christina Kunz, Thomas Hielscher, Hendrik Laue, Hartmut Goldschmidt, Stefan Delorme, Jens Hillengass
Erschienen in:
European Radiology
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Ausgabe 5/2016
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Abstract
Objectives
Aim of this prospective study was to investigate prognostic significance of increased bone marrow microcirculation as detected by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for survival and local complications in patients with multiple myeloma (MM).
Methods
We performed DCE-MRI of the lumbar spine in 131 patients with newly diagnosed MM and analysed data according to the Brix model to acquire amplitude A and exchange rate constant k
ep. In 61 patients a second MRI performed after therapy was evaluated to assess changes in vertebral height and identify vertebral fractures.
Results
Correlation analysis revealed significant positive association between beta2-microglobulin as well as immunoparesis with DCE-MRI parameters A and k
ep. Additionally, A was negatively correlated with haemoglobin levels and k
ep was positively correlated with LDH levels. Higher baseline k
ep values were associated with decreased vertebral height in a second MRI (P = 0.007) and A values were associated with new vertebral fractures in the lower lumbar spine (P = 0.03 for L4). Pre-existing lytic bone lesions or remission after therapy had no impact on the occurrence of vertebral fractures. Multivariate analysis revealed that amplitude A is an independent adverse risk factor for overall survival.
Conclusion
DCE-MRI is a non-invasive tool with significance for systemic prognosis and vertebral complications.
Key Points
• Qualitative parameters from DCE-MRI are correlated with established factors of disease activity
• Increased marrow microcirculation might be a risk factor for loss of vertebral height and fractures
• Amplitude A is an independent predictor for shortened overall survival