Purpose: To non-invasively assess bone marrow microcirculation before and after therapy in patients with newly diagnosed multiple myeloma (MM) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Experimental Design: 96 patients received DCE-MRI before and after primary treatment for newly diagnosed MM. For the 91 evaluable patients, treatment consisted of high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) in 82 patients and chemotherapy without ASCT in 9 patients. Additionally, 33 healthy volunteers were imaged as control group. Analysis of DCE-MRI was performed according to the two-compartment model by Brix to quantify amplitude A (associated with blood volume) and exchange rate constant kep (reflecting vessel permeability and perfusion). Results: Non-responders showed significantly higher A-values before the start of therapy compared to responders (p=0.02). In both, responders and non-responders to therapy, A-values dropped significantly (p=0.004 and <0.001, respectively) after primary therapy while lower values for kep were only found in responders (p<0.001). Depth of remission was significantly correlated to decreased bone marrow microcirculation: Patients in near complete (nCR) or complete remission (CR) after treatment showed significantly lower values for A compared to patients not achieving nCR+CR. The application of HDT or novel agents had no significant effect on DCE-MRI parameters after therapy, although patients treated with novel agents achieved more often nCR+CR (42%/12.5%;p<0.002). Higher kep-values at 2nd MRI were positively correlated to shorter overall survival (HR 3.53; 95% CI 1.21,10.33; p=0.02). Conclusions: Parameters from DCE-MRI are correlated to remission after primary therapy and outcome in newly diagnosed MM.
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 October 2016.
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