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COMy 2025 | Advances in imaging techniques for multiple myeloma and a potential new gold standard for imaging
Marco Talarico, MD, University of Bologna, Bologna, Italy, discusses advancements in imaging techniques for diagnosing and monitoring multiple myeloma (MM). Dr Talarico outlines the current role of FDG PET-CT for response assessment, while highlighting the growing evidence supporting whole-body diffusion-weighted MRI as a superior tool, particularly in assessing bone disease. He notes that other techniques are under investigation, which may hold theranostic potential, such as contrast-enhanced MRI and PET-CT with alternative tracers. This interview took place at the 11th World Congress on Controversies in Multiple Myeloma (COMy) congress in Paris, France.
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Transcript
Whole body low-dose CT is currently considered the minimal requirement for diagnosis of multiple myeloma-related bone disease, and PET-CT using FDG as a radiotracer is considered the standard technique regarding response assessment, in particular, regarding imaging MRD. However, the role of further functional imaging techniques is emerging in the latest years, and in particular, a gold role of whole body diffusion-weighted MRI, since it proved significantly superior versus PET-CT regarding assessment of bone disease, and it shows a good concordance in response assessment too...
Whole body low-dose CT is currently considered the minimal requirement for diagnosis of multiple myeloma-related bone disease, and PET-CT using FDG as a radiotracer is considered the standard technique regarding response assessment, in particular, regarding imaging MRD. However, the role of further functional imaging techniques is emerging in the latest years, and in particular, a gold role of whole body diffusion-weighted MRI, since it proved significantly superior versus PET-CT regarding assessment of bone disease, and it shows a good concordance in response assessment too.
Other functional imaging techniques are currently being investigated, in particular, diffusion-contrast enhanced MRI, but also use of PET-MRI and use of PET-CT with alternative radiotracers, with some having potential theranostic implications. However, I mean, use of whole-body-diffusion-weighted MRI has already proven significantly superior to PET-CT in baseline assessment and has a more advanced use also in response assessment, whereas other functional imaging techniques have been evaluated in earlier studies. So right now, May 2025, I can suggest that whole body diffusion-weighted MRI might become a new gold standard and an alternative to PET-CT. But I hope in the next years we will have further data also regarding other functional imaging techniques.
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