Imaging in Plasma-Cell Neoplasms: Italian Experts' Recommendations

Area of Science:

• Hematology
• Radiology
• Oncology

Background:

• Suboptimal imaging modalities hinder accurate detection of bone and extra-bone myeloma lesions.
• This impacts disease status recognition and timely treatment decisions for plasma cell disorders (PCD).
• A lack of systematic evidence review accompanied previous recommendations.

Purpose of the Study:

• To evaluate current real-world imaging practices in Italy for PCD.
• To identify factors and barriers affecting the adoption of international imaging guidelines.
• To create evidence-based, country-specific recommendations for PCD imaging assessment.

Main Methods:

• A national project initiated in 2024 involved 32 hematology centers and 5 radiology services.
• A survey assessed current practices and barriers.
• A Delphi panel of 23 experts achieved consensus on 25 recommendations.

Main Results:

• Survey data confirmed that suboptimal imaging modalities significantly contribute to under-recognized bone and extra-bone lesions.
• This leads to inaccurate disease staging and suboptimal treatment planning.
• Challenges in adopting international guidelines were identified.

Conclusions:

• Effective imaging is crucial for improving PCD detection and guiding treatment.
• The study successfully developed country-specific, evidence-based imaging recommendations for Italy.
• These recommendations aim to overcome barriers and enhance the adoption of international guidelines.