Prognostic significance of increased bone marrow microcirculation in newly diagnosed multiple myeloma

• Verfasst von: Merz, Maximilian [VerfasserIn]
• Verfasst von: Wagner, Barbara [VerfasserIn]
• Verfasst von: Jauch, Anna [VerfasserIn]
• Verfasst von: Hose, Dirk [VerfasserIn]
• Verfasst von: Goldschmidt, Hartmut [VerfasserIn]
• Verfasst von: Hillengaß, Jens [VerfasserIn]
• Titel: Prognostic significance of increased bone marrow microcirculation in newly diagnosed multiple myeloma
• Titelzusatz: results of a prospective DCE-MRI study
• Verf.angabe: Maximilian Merz, Thomas M. Moehler, Judith Ritsch, Tobias Bäuerle, Christian M. Zechmann, Barbara Wagner, Anna Jauch, Dirk Hose, Christina Kunz, Thomas Hielscher, Hendrik Laue, Hartmut Goldschmidt, Stefan Delorme, Jens Hillengass
• Jahr: 2016
• Jahr des Originals: 2015
• Umfang: 8 S.
• Fussnoten: Published online: 29 July 2015 ; Gesehen am 30.10.2019
• Titel Quelle: Enthalten in: European radiology
• Ort Quelle: Berlin : Springer, 1991
• Jahr Quelle: 2016
• Band/Heft Quelle: 26(2016), 5, Seite 1404-1411
• ISSN Quelle: 1432-1084
• ISSN Quelle: 1613-3757
• DOI: doi:10.1007/s00330-015-3928-4
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Angiogenesis
• Sach-SW: Dynamic contrast-enhanced MRI
• Sach-SW: Magnetic resonance imaging
• Sach-SW: Multiple myeloma
• Sach-SW: Vertebral fracture
• K10plus-PPN: 1680737414

Abstract

ObjectivesAim 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).MethodsWe 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 k ep. In 61 patients a second MRI performed after therapy was evaluated to assess changes in vertebral height and identify vertebral fractures.ResultsCorrelation analysis revealed significant positive association between beta2-microglobulin as well as immunoparesis with DCE-MRI parameters A and k ep. Additionally, A was negatively correlated with haemoglobin levels and k ep was positively correlated with LDH levels. Higher baseline k ep 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.ConclusionDCE-MRI is a non-invasive tool with significance for systemic prognosis and vertebral complications. Key Points • 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