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Blood, 2 April 2009, Vol. 113, No. 14, pp. 3161-3167. Prepublished online as a Blood First Edition Paper on November 6, 2008; DOI 10.1182/blood-2008-08-173104. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-08-173104v1 113/14/3161    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Shih, T. T.-F. Articles by Yang, P.-C. Search for Related Content PubMed PubMed Citation Articles by Shih, T. T.-F. Articles by Yang, P.-C. Related Collections Free Research Articles Myeloid Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Bone marrow angiogenesis magnetic resonance imaging in patients with acute myeloid leukemia: peak enhancement ratio is an independent predictor for overall survival Tiffany Ting-Fang Shih1, Hsin-An Hou2,3, Chieh-Yu Liu4, Bang-Bin Chen1, Jih-Luh Tang2, Hsuan-Yu Chen5, Shwu-Yuan Wei1, Ming Yao2, Shang-Yi Huang2, Wen-Chien Chou6, Szu-Chun Hsu6, Woei Tsay2, Chih-Wei Yu1, Chao-Yu Hsu1, Hwei-Fang Tien*,2, and Pan-Chyr Yang*,2 Departments of1 Medical Imaging and Radiology and 2 Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei; 3 Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County; 4 Biostatistics Consulting Laboratory, Department of Nursing, National Taipei College of Nursing, Taipei; 5 Institute of Statistical Science, Academia Sinica, Taipei; and 6 Department of Laboratory Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan 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 karyotype 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 therapy and to monitor treatment response. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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