Merz, M.M.MerzMoehler, T.M.T.M.MoehlerRitsch, J.J.RitschBäuerle, T.T.BäuerleZechmann, C.M.C.M.ZechmannWagner, B.B.WagnerJauch, A.A.JauchHose, D.D.HoseKunz, C.C.KunzHielscher, T.T.HielscherLaue, H.H.LaueGoldschmidt, H.H.GoldschmidtDelorme, S.S.DelormeHillengass, J.J.Hillengass2022-03-052022-03-052016https://publica.fraunhofer.de/handle/publica/24470410.1007/s00330-015-3928-42-s2.0-84937873718Objectives 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 kep. 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 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. Conclusion DCE-MRI is a non-invasive tool with significance for systemic prognosis and vertebral complications.en616journal article