Table 1.
Summary of advanced imaging modalities commonly used in the management of multiple myeloma.
| Radiation dose | Examination time | Sensitivity for detection of focal bone lesions | Key references evaluating the efficacy of cross-sectional imaging modalities | Key references evaluating the prognostic utility of cross-sectional imaging modalities | |
|---|---|---|---|---|---|
| Digital Skeletal Survey (SS) (Chest; antero-posterior (AP) and laterval views of the spine, humera, femora; lateral views of the skull; AP view of the pelvis) | 1.5–2.5 mSv | 10 min. (Patients are repositioned during the examination) | Low, compared to cross-sectional imaging techniques. | ||
| Whole body low dose CT (Vertex to mid- thighs), without iv contrast | 4–7 mSv | 5 min. | Superior to SS, particularly in the axial skeleton. Less sensitive | (28, 29) | |
| FDG-PET-CT (Vertex to mid-thighs) | Variable, based on institutional practice* | 60–90 min. wait time following tracer injection, then 20 min. scan time | Similar to MRI | (36, 38–40) | (46, 50, 53, 54, 63) |
| Axial MRI (Spine and pelvis) | None | 90 min. | Similar to PET-CT, limited by imaging field. | (32, 34) | (52) |
| Whole body MRI (Vertex to knees) | None | 90 min. | Similar to PET-CT. | (34–36, 39, 40) | (51, 54, 64, 65) |
*
Some institutional protocols obtain the CT portion of a PET-CT scan for the purpose of attenuation correction only.