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@ARTICLE{Merz:129237,
      author       = {M. Merz$^*$ and T. M. Moehler and J. Ritsch and T. Bäuerle
                      and C. M. Zechmann and B. Wagner$^*$ and A. Jauch and D.
                      Hose and C. Kunz$^*$ and T. Hielscher$^*$ and H. Laue and H.
                      Goldschmidt$^*$ and S. Delorme$^*$ and J. Hillengass$^*$},
      title        = {{P}rognostic significance of increased bone marrow
                      microcirculation in newly diagnosed multiple myeloma:
                      results of a prospective {DCE}-{MRI} study.},
      journal      = {European radiology},
      volume       = {26},
      number       = {5},
      issn         = {1432-1084},
      address      = {Berlin},
      publisher    = {Springer},
      reportid     = {DKFZ-2017-05242},
      pages        = {1404 - 1411},
      year         = {2016},
      abstract     = {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.},
      keywords     = {Contrast Media (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:26215436},
      doi          = {10.1007/s00330-015-3928-4},
      url          = {https://inrepo02.dkfz.de/record/129237},
}