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@ARTICLE{Merz:127124,
author = {M. Merz$^*$ and J. Ritsch and C. Kunz$^*$ and B. Wagner and
S. Sauer and D. Hose and T. Moehler and S. Delorme$^*$ and
H. Goldschmidt and C. Zechmann and J. Hillengass$^*$},
title = {{D}ynamic contrast-enhanced magnetic resonance imaging for
assessment of antiangiogenic treatment effects in multiple
myeloma.},
journal = {Clinical cancer research},
volume = {21},
number = {1},
issn = {1557-3265},
address = {Philadelphia, Pa. [u.a.]},
publisher = {AACR},
reportid = {DKFZ-2017-03150},
pages = {106 - 112},
year = {2015},
abstract = {To noninvasively assess bone marrow microcirculation before
and after therapy in patients with newly diagnosed multiple
myeloma with dynamic contrast-enhanced MRI
(DCE-MRI).Ninety-six patients received DCE-MRI before and
after primary treatment for newly diagnosed multiple
myeloma. For the 91 evaluable patients, treatment consisted
of high-dose therapy (HDT) with autologous stem cell
transplantation (ASCT) in 82 patients and chemotherapy
without ASCT in 9 patients. In addition, 33 healthy
volunteers were imaged as the control group. Analysis of
DCE-MRI was performed according to the two-compartment model
by Brix to quantify amplitude A (associated with blood
volume) and exchange rate constant kep (reflecting vessel
permeability and perfusion).Nonresponders showed
significantly higher A-values before the start of therapy
compared with responders (P = 0.02). In both responders and
nonresponders to therapy, A-values dropped significantly (P
= 0.004 and <0.001, respectively) after primary therapy,
whereas lower values for kep were found only in responders
(P < 0.001). Depth of remission was significantly correlated
to decreased bone marrow microcirculation: Patients in near
complete response (nCR) or complete remission (CR) after
treatment showed significantly lower values for A compared
with patients not achieving nCR+CR. The application of HDT
or novel agents had no significant effect on DCE-MRI
parameters after therapy, although patients treated with
novel agents more often achieved nCR+CR $(42\%/12.5\%;$ P <
0.002). Higher kep-values at second MRI were positively
correlated to shorter overall survival (HR 3.53; $95\%$
confidence intervals, 1.21-10.33; P = 0.02).Parameters from
DCE-MRI are correlated to remission after primary therapy
and outcome in newly diagnosed multiple myeloma.},
keywords = {Angiogenesis Inhibitors (NLM Chemicals)},
cin = {E010 / C060},
ddc = {610},
cid = {I:(DE-He78)E010-20160331 / I:(DE-He78)C060-20160331},
pnm = {315 - Imaging and radiooncology (POF3-315)},
pid = {G:(DE-HGF)POF3-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:25351744},
doi = {10.1158/1078-0432.CCR-14-1029},
url = {https://inrepo02.dkfz.de/record/127124},
}