Angiogenesis in hematological malignancy - Evaluated by dynamic contrast-enhanced MRI

Bone marrow angiogenesis can be measured by DCE-MRI. DCE-MRI is an imaging technique that appears to provide quantitative and biologically relevant information related to tumor vasculature and angiogenesis, which can inform novel drug efficacy, monitor treatment response and act as an imaging biomarker to predict treatment outcome and survival in hematological malignant patients. Increased bone marrow perfusion as reflected by higher Peak value can independently predict adverse clinical outcome in patients with acute myeloid leukemia (AML). In addition, DCE-MRI derived data of bone marrow in AML patients at remission status provides useful information on clinical outcome of patients who might have relapse or not. Patients with a higher value for Kep at remission status would have shorter relapse-free duration and may need to undergo additional therapy. In multiple myeloma, DCE-MRI data correlate strongly with marrow tissue microvessel density. Studies identify high Amplitude values as a possible risk factor associated with the development of extra-medullary disease in multiple myeloma patients; these findings partly support the hypothesis that bone marrow angiogenesis may play role in the development of extra-medullary disease in multiple myeloma. DCE-MRI derived-parameters could serve as a guidance for the selection of optimal management plans, thereby contributing to the development of “personalized medicine” for patient.