Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Assessment of Antiangiogenic Treatment Effects in Multiple Myeloma

Purpose: To noninvasively assess bone marrow microcirculation before and after therapy in patients with newly diagnosed multiple myeloma with dynamic contrast-enhanced MRI (DCE-MRI). Experimental Design: Ninety-six patients received DCE-MRI before and after primary treatment for newly diagnosed multiple myeloma. 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. In addition, 33 healthy volunteers were imaged as the 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 k ep (reflecting vessel permeability and perfusion). Results: Nonresponders showed significantly higher A-values before the start of therapy compared with responders ( P = 0.02). In both responders and nonresponders to therapy, A-values dropped significantly ( P = 0.004 and ep were found only in responders ( P P ep -values at second MRI were positively correlated to shorter overall survival (HR 3.53; 95% confidence intervals, 1.21–10.33; P = 0.02). Conclusion: Parameters from DCE-MRI are correlated to remission after primary therapy and outcome in newly diagnosed multiple myeloma. Clin Cancer Res; 21(1); 106–12. ©2014 AACR .