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Prognostic significance of increased bone marrow microcirculation in newly diagnosed multiple myeloma: Results of a prospective DCE-MRI study

: Merz, M.; Moehler, T.M.; Ritsch, J.; Bäuerle, T.; Zechmann, C.M.; Wagner, B.; Jauch, A.; Hose, D.; Kunz, C.; Hielscher, T.; Laue, H.; Goldschmidt, H.; Delorme, S.; Hillengass, J.


European radiology 26 (2016), Nr.5, S.1404-1411
ISSN: 0938-7994
ISSN: 1613-3749
ISSN: 1432-1084
Fraunhofer MEVIS ()

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.