How often should imaging be repeated for someone diagnosed with active or smoldering myeloma?

[Music] how often should imaging be repeated for someone diagnosed with smoldering myeloma so starting with smoldering i would usually recommend once a year or if there are changes in the serological markers if there's a rise of m protein or i don't know hemoglobin lower calcium higher creatinine higher so other reasons for suspicion of progression then it would repeat again how often should imaging be repeated for someone diagnosed with active myeloma in symptomatic myeloma we do the first diagnosis to assess the disease at after treatment to see how much is left of the disease and with the newer techniques if we use pet ct and low-dosity and mri it's usually enough to do another imaging and relapse or at any sign of serological changes i had a few patients who had no changes in serological markers but had changes in the bone marrow so sometimes it's warranted there pad ct helps us also beyond just a myeloma assessment we also learn about if there are other tumors developing because we know that up to 10 of patients can develop secondary cancers after high-dose chemotherapy with lenalidomide maintenance treatment so that's another kind of additional question that we can ask for imaging after after treatment [Music]