Bone marrow angiogenesis magnetic resonance imaging in patients with acute myeloid leukemia: Peak enhancement ratio is an independent predictor for overall survival
Journal
Blood
Journal Volume
113
Journal Issue
14
Pages
3161-3167
Date Issued
2009
Author(s)
Liu C.-Y.
Chen H.-Y.
Wei S.-Y.
Abstract
Emerging evidence suggests that progression of hematologic malignancies is associated with angiogenesis. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can provide global and functional imaging of tumor angiogenesis. In this study, we performed bone marrow DCE-MRI prospectively at diagnosis and after induction chemotherapy in 78 de novo acute myeloid leukemia (AML) patients and correlated it with treatment outcome. An algorithm to assess bone marrow angiogenesis by measuring the DCE-MRI time-intensity curve pixel by pixel was developed using 3 distinct parameters: peak enhancement ratio (Peak) to indicate tissue blood perfusion; amplitude (Amp) to reflect vascularity; and volume transfer constant (K trans) to indicate vascular permeability. The Peak and Amp decreased significantly at remission status after induction chemotherapy. Patients with higher Peak or Amp at diagnosis had shorter overall survival and disease-free survival than others. Cox multivariate analysis identified higher Peak value (hazard ratio, 9.181; 95% confidence interval, 1.740-48.437; P = .009) as an independent predictor for overall survival in addition to unfavorable karyo-type and old age. Our findings provide evidence that increased bone marrow angiogenesis measured by DCE-MRI can predict adverse clinical outcome in AML patients. DCE-MRI may help to select high-risk phenotype AML patients for tailored antiangiogenic therapyand to monitor treatment response. ? 2009 by The American Society of Hematology.
SDGs
Other Subjects
anthracycline; cytarabine; idarubicin; retinoic acid; acute granulocytic leukemia; adult; angiogenesis; article; blood vessel permeability; bone marrow; cancer chemotherapy; disease free survival; drug megadose; female; hematopoietic stem cell transplantation; high risk patient; human; karyotype; major clinical study; male; multivariate analysis; nuclear magnetic resonance imaging; outcome assessment; overall survival; predictor variable; priority journal; prospective study; remission; tissue perfusion; treatment duration; treatment outcome; treatment response
Type
journal article