Dynamic Contrast-enhanced MR Imaging Measurement of Vertebral Bone Marrow Perfusion May Be Indicator of Outcome of Acute Myeloid Leukemia Patients in Remission-猫眼课题宝

DOI：

10.1148/radiol.10100995

发表时间：

2011-03-01

期刊：

RADIOLOGY

影响因子：

19.7

通讯作者：

中科院分区：

医学1区

文献类型：

作者：

Chen, Bang-Bin;Hsu, Chao-Yu;Shih, Tiffany Ting-Fang

目的：探讨急性髓系白血病(AML)完全缓解(CR)患者骨髓动态增强磁共振(DCE)成像与预后和生存期的关系。材料与方法：2004年9月至2007年10月，经机构评审委员会批准并征得知情同意后，在96例新发AML患者中，51例(女性29例，男性22例；平均年龄43.5岁；年龄17~66岁)接受动态对比剂增强磁共振(DCE)检查。计算了两个半定量参数(峰值和斜率)和另外三个定量参数(幅度、K-Ep和K-el[消除速率常数])。总生存期(OS)和无复发生存期(RFS)采用Kaplan-Meier模型，高、低DCE值患者组之间的差异采用双侧对数列检验。结果：中位随访时间为25.9个月。单因素分析结果显示，波峰、斜率、波幅和K-EP的高值分别与较短的OS相关(P分别为0.004、0.01、0.034和0.026)。此外，K-EP值越高，RFS越短(P=0.008)。当将年龄、性别和初诊核型纳入多因素Cox比例风险分析后，结果显示只有K-EP，而不是其他DCEMR成像参数是OS(相对风险[RR]，30.305；P=0.021)和RFS(RR，6.477；P=0.009)的独立因素。结论：DCEMR成像测量的急性髓系白血病患者的骨髓血流灌注可以作为预后和生存的指标。用动力学模型测量的K-EP是有用的，并且与RFS显著相关，而启发式参数(峰值和斜率)则不是。(C)RSNA，2011年

Purpose: To examine whether dynamic contrast material-enhanced (DCE) magnetic resonance (MR) imaging measurement of bone marrow perfusion in acute myeloid leukemia (AML) patients in complete remission (CR) is associated with outcome and survival.Materials and Methods: After institutional review board approval and informed consent were obtained, from September 2004 to October 2007, 51 patients (29 women, 22 men; mean age, 43.5 years; range, 17-66 years) agreed to undergo DCE MR imaging to assess bone marrow perfusion, among 96 patients with newly diagnosed de novo AML who had received induction chemotherapy and achieved CR. Two semiquantitative parameters (peak and slope) and another three quantitative parameters (amplitude, K-ep [efflux rate constant], and K-el [elimination rate constant]) were calculated. Overall survival (OS) and relapse-free survival (RFS) were assessed with the Kaplan-Meier model, while differences between patient groups with high and low DCE MR imaging parameter values were assessed by using the two-sided log-rank test.Results: The median follow-up was 25.9 months. Univariate analysis results showed that high values of peak (>= 0.42), slope (>= 0.0235), amplitude (>= 0.03), and K-ep (>= 0.0082) were associated with shorter OS (P = .004, 0.01, 0.034, and 0.026, respectively). Besides, a high value of K-ep was also associated with shorter RFS (P = .008). When age, sex, and initial karyotype at diagnosis were included in multivariate Cox proportional hazards analysis, the results showed that only K-ep, but not other DCE MR imaging parameters, was an independent factor for OS (relative risk [RR], 30.305; P = .021) and RFS (RR, 6.477; P = .009).Conclusion: Bone marrow perfusion measured with DCE MR imaging in AML patients in CR can be an indicator of outcome and survival. K-ep measured with kinetic modeling was useful and significantly associated with RFS, while heuristic parameters (peak and slope) were not. (C)RSNA, 2011

Dynamic Contrast-enhanced MR Imaging Measurement of Vertebral Bone Marrow Perfusion May Be Indicator of Outcome of Acute Myeloid Leukemia Patients in Remission

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