TY  - JOUR
AU  - Merz, Maximilian
AU  - Moehler, Thomas M
AU  - Ritsch, Judith
AU  - Bäuerle, Tobias
AU  - Zechmann, Christian M
AU  - Wagner, Barbara
AU  - Jauch, Anna
AU  - Hose, Dirk
AU  - Kunz, Christina
AU  - Hielscher, Thomas
AU  - Laue, Hendrik
AU  - Goldschmidt, Hartmut
AU  - Delorme, Stefan
AU  - Hillengass, Jens
TI  - Prognostic significance of increased bone marrow microcirculation in newly diagnosed multiple myeloma: results of a prospective DCE-MRI study.
JO  - European radiology
VL  - 26
IS  - 5
SN  - 1432-1084
CY  - Berlin
PB  - Springer
M1  - DKFZ-2017-05242
SP  - 1404 - 1411
PY  - 2016
AB  - 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).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 kep. In 61 patients a second MRI performed after therapy was evaluated to assess changes in vertebral height and identify vertebral fractures.Correlation analysis revealed significant positive association between beta2-microglobulin as well as immunoparesis with DCE-MRI parameters A and kep. Additionally, A was negatively correlated with haemoglobin levels and kep was positively correlated with LDH levels. Higher baseline kep 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.DCE-MRI is a non-invasive tool with significance for systemic prognosis and vertebral complications.• 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.
KW  - Contrast Media (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:26215436
DO  - DOI:10.1007/s00330-015-3928-4
UR  - https://inrepo02.dkfz.de/record/129237
ER  -