Target Volume Determination 2015

Physiological correlates

Normal spine

Diffuse infiltration by multiple myeloma

Relative blood volume Interstitial space

Amplitude

Perf > Diff Diff > Perf

Diffusion Perfusion

k ep

Diffusion = Transcapillary exchange Depends on: Permeability, capillary exchange surface

Time-intensity curve

T1w post contrast FS Parameter image

Amplitude vs. infiltration degree

Amplitude vs. vessel density

Prognostic information of DCE-MRI

0.6

0.6

n=65

0.5

0.5

0.4

0.4

p<0.01

p<0.01

0.3

0.3

n = 11

n = 18

0.2

0.2

Normalized amplitude

n = 6

n = 5

0.1

0.1

0.0

0.0

Lowvesseldensity Highvesseldensity

Low infiltration degree

High infiltration degree

Months since first dMRI

Nosas-Garcia et al., 2005

Nosas-Garcia et al., 2005

Hillengass et al., Clin Cancer Res 2007