[Functional magnetic resonance tomography in the diagnosis and therapy monitoring in multiple myeloma].
OBJECTIVE
Investigation of the quantitative microcirculation parameters amplitude A and exchange rate constant k21 determined by contrast-enhanced dynamic magnetic resonance imaging (d-MRI) in multiple myeloma (MM).


METHODS
d-MRT of lumbar spine and right spina iliaca superior posterior of 16 controls (ctr) and 35 patients with active MM. Generation of colour-coded images of microcirculation parameters superimposed onto static MRI images.


RESULTS
Amplitude A and k21 parameters were significantly increased in patients with MM and down modulated by therapy in 7 of 8 MM cases in a follow-up investigation [p < 0.01; median Actr = 0.2 (0.09-0.4); median AMM = 0.93 (0.2-1.52); median k21ctr = 0.09 min-1 (0.03-0.9); median k21MM = 4.57 min-1 (0.21-23.8)]. Thirteen patients revealed a "diffuse" and 22 a "focal" pattern of distribution of microcirculation parameters. Bone marrow biopsies in 8 cases revealed an correlation between bone marrow plasma cell infiltration and increased microcirculation parameters.


CONCLUSIONS
Identification of microcirculation changes by d-MRI is a novel imaging technique for the detection and monitoring of MM bone lesions.
Moehler
T M
TM
Medizinische Klinik und Poliklinik V (Hämatologie/Onkologie/Rheumatologie), Ruprecht-Karls-Universität Heidelberg. Thomas_Moehler@med.uni-heidelberg.de
Hawighorst
H
H
Neben
K
K
Egerer
G
G
Benner
A
A
Hillengass
J
J
Max
R
R
Ho
A D
AD
Goldschmidt
H
H
van Kaick
G
G
D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D016903:Drug Monitoring / Q000379:methods; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007085:Ilium / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D007150:Immunohistochemistry; D008159:Lumbar Vertebrae / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D008833:Microcirculation / Q000378:metabolism / Q000473:pathology; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D013792:Thalidomide / Q000008:administration & dosage
D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D000972:Antineoplastic Agents, Phytogenic; D013792:Thalidomide; D005047:Etoposide; D003907:Dexamethasone; D003520:Cyclophosphamide