Role of DCE-MRI in the Diagnosis and Treatment of Multiple Myeloma (MM)

1. ‌Assessing Tumor Angiogenesis and Activity‌

• DCE-MRI dynamically monitors the ‌distribution and metabolism of contrast agents‌ within tissues, reflecting tumor ‌vascular permeability‌, ‌blood flow perfusion‌, and ‌microcirculation characteristics‌. This allows evaluation of myeloma angiogenesis levels and tumor cell activity‌12. Quantitative parameters (e.g., vascular volume fraction, permeability) can be used to analyze abnormalities in the tumor vascular system‌.

2. ‌Aiding Early Diagnosis and Lesion Detection‌

• Compared to conventional imaging, DCE-MRI is more sensitive in detecting ‌early bone marrow infiltration‌ before visible bone destruction occurs, particularly for subtle blood flow changes in focal or diffuse marrow infiltration‌.

3. ‌Monitoring Treatment Efficacy and Dynamic Evaluation‌

• During therapy, DCE-MRI tracks ‌hemodynamic changes‌ in lesions, such as contrast agent inflow/outflow rates and peak enhancement, to assess the suppression of tumor vasculature by chemotherapy, targeted therapy, or immunotherapy‌.
• Combined with ‌ADC values from diffusion-weighted imaging (DWI)‌, it provides a comprehensive evaluation of tumor cell activity and microstructural changes, improving the accuracy of treatment response assessment‌.

4. ‌Prognostic Prediction and Risk Stratification‌

• DCE-MRI findings like ‌high vascular permeability‌, ‌abnormal perfusion patterns‌, and ‌intense enhancement‌ correlate with MM aggressiveness and poor prognosis‌25. For example, lesions with active angiogenesis may indicate faster disease progression or drug resistance‌.

5. ‌Complementarity with Other Imaging Modalities‌

• When combined with ‌whole-body MRI (WB-MRI)‌, DCE-MRI provides a holistic assessment of bone marrow infiltration extent, bone destruction severity, and soft tissue lesions, addressing limitations of PET-CT in vascular function evaluation‌.

Considerations

• DCE-MRI results should be interpreted alongside clinical data and other imaging (e.g., DWI, T1/T2 sequences) to avoid misjudgment based on isolated parameters‌36.
• Contrast agent use requires evaluation of patient ‌renal function‌ and ‌allergy history‌, with strict adherence to safety protocols‌.

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By integrating these functions, DCE-MRI offers ‌functional assessment‌ and ‌dynamic monitoring‌ in MM precision medicine, playing a critical role in guiding personalized treatment strategies‌.