It may be time to meet with your radiologist to review your myeloma imaging tests. Imaging technologies have advanced greatly in the past few years and have become a new and important vehicle for diagnosis and prognosis. Dr. Jens Hillengass is a world renown expert on imaging techniques in multiple myeloma and shares his key learning about the technology in this show. He first shares that the traditional x-ray or skeletal survey does not provide as much information as the CT scan. Work is now being done by the International Myeloma Working Group to make CT the new gold standard over x-ray. He shares the importance of PET and MRI to see inside of the bone marrow and discusses the important use of MRI to identify unique patterns of lesions in the bone marrow: focal lesions, diffuse infiltration and a salt and pepper pattern. The number of lesions and the presence of the diffuse infiltration pattern are important for prognosis based on his research. He tells us that about a third of patients have focal lesions only and another third have diffuse only while the last third have both. If patients have more than 7 focal lesions, a dense diffuse pattern or both focal lesions and the diffuse infiltration, they have worse prognosis, but that prognosis needs to bear in mind a holistic view of each patient that also looks at LDH levels, cytogenetics and imaging results together. He gives recommendations about what imaging techniques newly diagnosed patients should receive and also shares his important recommendations for smoldering myeloma patients. This is a key show for patients who want to take charge of their care and know what questions to ask their doctor for their most accurate diagnosis and prognosis. The Myeloma Crowd Radio Show with Dr. Jens Hillengass, MD