title: Dynamic contrast-enhanced MRI for assessing the disease activity of multiple myeloma: a comparative study with histology and clinical markers.
abstract: OBJECTIVE
  To examine whether parameters of dynamic, contrast-enhanced MRI (DCE MRI) reflect the degree of infiltration and vessel density in corresponding bone marrow biopsy specimens.
  
  
  METHODS
  The pelvis of 24 patients with multiple myeloma (MM) was examined using contrast-enhanced DCE MRI. Biopsy was obtained from the spina iliaca posterior superior. Using a two-compartment model (assuming one intravascular and one interstitial compartment), the parameters amplitude (A, the maximum, relative signal increase over baseline) and the exchange rate constant (k(ep), describing the redistribution of contrast agent from the interstitial into the intravascular compartment) in the biopsied region were calculated and compared with the histological and clinical data.
  
  
  RESULTS
  DCE MRI parameters were significantly higher in lesions with marked infiltration than with mild or no infiltration (P < 0.05). The amplitude normalized to that in the iliac artery (A(n)), but not k(ep), was higher in lesions with high vessel-density at histology (P = 0.01). Higher k(ep) levels were found in presence of increased serum immunoglobulins.
  
  
  CONCLUSIONS
  Increased contrast uptake in the bone marrow of MM patients indicates at least moderate tumor involvement. Furthermore, the contrast enhancement correlates with vessel-density and serum markers of disease activity.
authors.affiliation: Department of Radiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Nosàs-Garcia
authors.forename: Thomas
authors.initials: T
authors.lastname: Moehler
authors.forename: Klaus
authors.initials: K
authors.lastname: Wasser
authors.forename: Fabian
authors.initials: F
authors.lastname: Kiessling
authors.forename: Reiner
authors.initials: R
authors.lastname: Bartl
authors.forename: Ivan
authors.initials: I
authors.lastname: Zuna
authors.forename: Jens
authors.initials: J
authors.lastname: Hillengass
authors.forename: Hartmut
authors.initials: H
authors.lastname: Goldschmidt
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.forename: Stefan
authors.initials: S
authors.lastname: Delorme
mesh_terms: D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007136:Immunoglobulins / Q000097:blood; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology
chemical_list: D015415:Biomarkers; D007136:Immunoglobulins