Imaging of Multiple Myeloma: Present and Future

Area of Science:

• Radiology
• Oncology
• Hematology

Background:

• Multiple myeloma (MM) is a prevalent adult hematologic malignancy.
• Early intervention in high-risk, asymptomatic patients improves survival.
• Bone and bone marrow lesion detection via imaging guides MM treatment decisions.

Purpose of the Study:

• To provide an updated overview of imaging techniques for multiple myeloma (MM).
• To discuss indications, advantages, limitations, and reporting standards for MM imaging.
• To explore differential diagnoses, pitfalls, and future directions in MM imaging.

Main Methods:

• Review of current literature on multiple myeloma (MM) imaging.
• Analysis of low-dose whole-body CT, dual-energy CT, MRI, and FDG-PET/CT.
• Discussion of emerging techniques like diffusion-weighted MRI and PET-MRI.

Main Results:

• Low-dose whole-body CT is standard for initial MM assessment.
• MRI shows higher sensitivity and specificity for lesion detection than FDG-PET/CT.
• FDG-PET/CT is recommended for MM follow-up; diffusion-weighted MRI offers quantitative assessment.

Conclusions:

• Standardized reporting for MM imaging is proposed to reduce variability.
• Advanced imaging techniques like dual-energy CT and diffusion-weighted MRI show promise.
• Future research directions include PET-MRI and artificial intelligence applications in MM diagnosis and management.