@article{3125792,
    title = "Dynamic contrast-enhanced magnetic resonance imaging parameters correlate with advanced revised-ISS and angiopoietin-1/angiopoietin-2 ratio in patients with multiple myeloma",
    author = "Terpos, E. and Matsaridis, D. and Koutoulidis, V. and Zagouri, F. and Christoulas, D. and Fontara, S. and Panourgias, E. and Gavriatopoulou, M. and Kastritis, E. and Dimopoulos, M.A. and Moulopoulos, L.A.",
    journal = "Annals of Hematology",
    year = "2017",
    volume = "96",
    number = "10",
    pages = "1707-1714",
    publisher = "Springer-Verlag",
    issn = "0939-5555, 1432-0584",
    doi = "10.1007/s00277-017-3078-7",
    keywords = "angiopoietin 1;  angiopoietin 2;  antineoplastic agent;  beta 2 microglobulin;  bortezomib;  contrast medium;  creatinine;  hemoglobin;  lenalidomide;  M protein;  thalidomide;  vasculotropin;  angiopoietin 1;  angiopoietin 2;  ANGPT1 protein, human;  ANGPT2 protein, human;  tumor protein, adult;  aged;  angiogenesis;  Article;  autologous stem cell transplantation;  bone disease;  cancer prognosis;  cancer survival;  clinical article;  controlled study;  creatinine blood level;  dynamic contrast-enhanced magnetic resonance imaging;  enzyme linked immunosorbent assay;  estimated glomerular filtration rate;  female;  human;  male;  multiple myeloma;  overall survival;  pelvis;  priority journal;  prospective study;  protein blood level;  sensitivity and specificity;  thoracolumbar spine;  blood;  comparative study;  diagnostic imaging;  middle aged;  multiple myeloma;  nuclear magnetic resonance imaging;  spine;  very elderly, Aged;  Aged, 80 and over;  Angiopoietin-1;  Angiopoietin-2;  Female;  Humans;  Magnetic Resonance Imaging;  Male;  Middle Aged;  Multiple Myeloma;  Neoplasm Proteins;  Pelvis;  Spine",
    abstract = "The aim of the study was to assess the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with newly diagnosed multiple myeloma (MM) who were treated with novel anti-myeloma agents. We studied 60 previously untreated MM patients at diagnosis, 14 with smoldering MM (SMM) and 5 with MGUS. All patients underwent MRI of the thoracolumbar spine and pelvis before the administration of any kind of therapy, and DCE-MRI was performed. The MRI perfusion parameters evaluated were wash-in (WIN), washout (WOUT), time-to-peak (TTPK), time-to-maximum slope (TMSP), and the WIN/TMSP ratio. The following serum levels of angiogenic cytokines were measured on the day of MRI: VEGF, angiogenin (Ang), angiopoietin-1 (Angp-1), and −2 (Angp-2). Symptomatic MM patients had increased WIN compared to SMM (p < 0.05) and MGUS patients (p = 0.001). TTPK was decreased, and WIN/TMSP was increased in both symptomatic and SMM patients compared to MGUS patients (p < 0.05). Symptomatic MM patients had decreased TMSP compared to MGUS patients. The Angp-1/Angp-2 ratio was reduced in symptomatic MM compared to SMM (p = 0.017) and MGUS patients (p < 0.001). TTPK correlated with Angp-1/Angp-2 ratio and importantly with R-ISS. Patients with R-ISS-3 had lower TTPK median value (23 s, range 18–29 s) compared to patients with R-ISS-2 (48 s, range 27–68 s) and patients with R-ISS-1 MM (54 s, range 42–76 s; p ANOVA = 0.01). A subset of patients with low TTPK (lower quartile) had shorter time to progression compared to all other patients. These data suggest that certain DCE-MRI parameters correlate with R-ISS and adverse prognostic features of angiogenesis, such as the ratio of Angp-1/Angp-2. © 2017, Springer-Verlag GmbH Germany."
}