[Dynamic contrast-enhanced MRI for evaluating bone marrow microcirculation in malignant hematological diseases before and after thalidomide therapy].

Abstract

PURPOSE:

The aim of the study was to measure microcirculation parameters by dynamic contrast-enhanced MRI (d-MRI) and to evaluate the anti-angiogentic effects during treatment with thalidomide in different hematologic malignancies.

METHODS:

In 20 healthy normal persons, 20 patients with myelodysplastic syndromes (MDS), 10 patients with multiple myeloma (MM) and 10 with myelofibrosis (MF) a fast gradient echo sequence (Turbo fast low angle shot 2D) with a pump controlled bolus infusion of gadolinium-DTPA was performed before and in 18 of these after beginning (average of 4.3 months) of a thalidomide therapy. Two pharmacokinetic parameters--the amplitude and exchange-rate-constant--were calculated and a statistical comparison of these values between healthy persons and patients as well as a correlation with the clinical course was executed.

RESULTS:

Compared with the normal controls the patients showed a higher amplitude (normal persons 14.4 +/- 5.2, MDS 24.8 +/- 8.1, MF 35.9 +/- 4.3, MM 23.4 +/- 3.6) and exchange-rate-constant (normal persons 0.124 +/- 0.042, MDS 0.136 +/- 0.036, MF 0.144 +/- 0.068, MM 0.131 +/- 0.034). In the d-MRI-follow-up examinations a significant (p < 0.005) reduction of the amplitude and exchange rate constant values was evident in 14 of 18 patients undergoing a thalidomide therapy. Clinically all of these patients showed a therapy responding with complete or partial diseases remission.

CONCLUSIONS:

In patients with hematologic malignancies significantly higher d-MRI-microcirculation parameters of the lumbar spine can be demonstrated than in normal persons. During anti-angiogenetic treatment with thalidomide a decrease of these values was observed in case of a responding to therapy.

• Authors: A Scherer, C Strupp, H J Wittsack, V Engelbrecht, R Willers, U Germing, N Gattermann, R Haas, U Mödder
• Journal: Der Radiologe (Radiologe) Vol. 42 Issue 3 Pg. 222-30 (Mar 2002) ISSN: 0033-832X [Print] Germany
• Vernacular Title: Dynamische kontrastverstärkte MRT zur Beurteilung der Knochenmarksmikrozirkulation bei malignen hämatologischen Erkrankungen vor und während einer Thalidomidtherapie.
• PMID: 11963240 (Publication Type: English Abstract, Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Contrast Media
• Thalidomide
• Gadolinium DTPA

Topics

• Adult
• Aged
• Angiogenesis Inhibitors (adverse effects, therapeutic use)
• Bone Marrow (blood supply)
• Contrast Media
• Female
• Gadolinium DTPA
• Humans
• Image Enhancement
• Image Processing, Computer-Assisted
• Lumbar Vertebrae (blood supply)
• Magnetic Resonance Imaging
• Male
• Microcirculation (drug effects)
• Middle Aged
• Multiple Myeloma (diagnosis, drug therapy)
• Myelodysplastic Syndromes (diagnosis, drug therapy)
• Neovascularization, Pathologic (diagnosis, drug therapy)
• Primary Myelofibrosis (diagnosis, drug therapy)
• Thalidomide (adverse effects, therapeutic use)
• Treatment Outcome