Table 2. Comparison of Imaging Modalities for Multiple Myeloma.

	Strong Point	Weak Point
CSS	• Low cost • Easy accessibility	• Low sensitivity to detection of bone lesions • A significant amount of bone must be lost to be seen on X-rays • Long acquisition time • Limited bone marrow evaluation • Difficulty in distinguishing between benign and malignant compression fractures • Difficulty evaluating treatment responses
LDWBCT	• Higher sensitivity than CSS to osteolytic lesions • A biopsy, surgery or radiation treatment plan may be available • Possible to detect extramedullary lesions • Cheaper than PET/CT or WBMR	• Radiation exposure • Difficulty evaluating treatment responses • Higher cost than CSS • Unable to identify lesions prior to bone destruction or diffuse lesions in the bone marrow
Whole body MRI	• No radiation exposure • Both diffuse or focal bone marrow lesions can be detected • High sensitivity to detect bone marrow lesions • Good for detecting extramedullary lesions or compression fractures • Can be used for prognostic evaluation • A biopsy, surgery or radiation treatment plan may be available	• Higher cost compared to CSS and LDWBCT • Long acquisition time
PET/CT	• Possible to evaluate the activity of the disease before and after treatment • Ability to evaluate extramedullary lesions • CT component can define lytic diseases	• Higher cost compared to CSS and LDWBCT • Long acquisition time • Radiation exposure • High false positive rate • Poor resolution

Adapted from Lee et al. Korean J Radiol 2021;22:1497-1513 (7).

CSS = conventional skeletal survey, LDWBCT = low dose whole body CT