When it comes to multiple myeloma, imaging isn't just a diagnostic tool. It's a critical part of understanding how the disease is behaving, progressing, or responding to treatment. But with so many imaging options out there, x-rays, CTs, MRIs, PET scans, how do you know which one is best and when? That's where the International Myeloma Working Group, IMWG, steps in. They've developed expert consensus guidelines to help doctors and patients around the world make smarter, more consistent decisions about imaging and myeloma care. In this video, we'll break down exactly what those guidelines say, what scans to use, when to use them, and why it matters. Whether you're newly diagnosed, living with smoldering myeloma, in remission, or experiencing a relapse, understanding these recommendations can empower you to take a more active role in your care. What are the International Myeloma Working Group's consensus imaging guidelines for myeloma? The new guidelines is in which stage of disease do you get which imaging. So in MGUS, we usually say if a patient has a low risk, intermediate risk, MGUS, it does really not make sense to do an imaging that would be an overkill because we, I don't know how many thousand patients would find one non-secretory myeloma and usually those patients already have other issues. So it's not really worth the screening. In smoldering myeloma, we say as a screening, in high risk MGUS and smoldering myeloma, we recommend a CT. If CT is positive, then you have a myeloma because of oscillated lesions. If CT is negative, then we recommend an MRI because it's more sensitive and we would see changes before the actual bone destruction has happened. So that's kind of the sequence there. And as I mentioned in symptomatic myeloma, a CT to assess the bone disease is the most important thing and if you have the ability to add a PET, you also get this information on the tumor burden at the same time. And then the next step is kind of after treatment where we recommend PET CT to look for how the bone disease is developed because sometimes also over treatment, even though there's no progression, still weakened bones can fracture and that CT gives us a good baseline for when the disease comes back later on at the relapse and the PET gives us information about residual activity after treatment. And at relapse, it's basically the same as at first diagnosis. We want to know the tumor burden. We want to know the bone involvement. So either CT or if available, PET CT. Managing is a powerful tool in managing multiple myeloma and the IMWG guidelines help ensure it's used in the most effective evidence-based way. Whether it's diagnosing active disease, monitoring smoldering myeloma, or assessing response to treatment, choosing the right scan at the right time can make a real difference in patient care. If you're living with myeloma, understanding these guidelines can help you have more informed conversations with your care team. You can access the full IMWG imaging consensus guidelines here. This resource provides detailed insights into the recommended imaging strategies for multiple myeloma patients. Thanks for watching. If you found this helpful, don't forget to like, subscribe, and share. See you in the next video.
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