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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 11, 2008 Accepted October 21, 2008 Bone marrow angiogenesis MR imaging in patients with acute myeloid leukemia: Peak enhancement ratio is an independent predictor for overall survival Tiffany Ting-Fang Shih, Hsin-An Hou, Chieh-Yu Liu, Bang-Bin Chen, Jih-Luh Tang, Hsuan-Yu Chen, Shwu-Yuan Wei, Ming Yao, Shang-Yi Huang, Wen-Chien Chou, Szu-Chun Hsu, Woei Tsay, Chih-Wei Yu, Chao-Yu Hsu, Hwei-Fang Tien, and Pan-Chyr Yang* Department of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Biostatistics Consulting Laboratory, Department of Nursing, National Taipei College of Nursing, Taipei, Taiwan Institute of Statistical Science, Academia Sinica, Taipei, Taiwan Department of Laboratory Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan * Corresponding author; email: pcyang{at}ntu.edu.tw. Emerging evidence suggests that progression of hematological 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 three 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% CI 1.740-48.437, P=0.009) 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 anti-angiogenic therapy and monitor treatment response. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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