Imaging in multiple myeloma: Computed tomography or magnetic resonance imaging?

Multiple myeloma ( MM) is the second most common type of hematological disease with its incidence rising in the elderly. In MM, the extent of the bone disease increases both morbidity and mortality. The detection of lytic bone lesions on imaging, especially computerized tomography (CT) and magnetic resonance imaging ( MRI) is crucial to separate asymptomatic from symptomatic MM patients even when no clinical symptoms are present. Although radiology is essential in the staging and management of patients with MM there is still high variability in the choice between MRI and CT. In addition, there is still suboptimal agreement among readers. The potential of medical imaging in MM is largely under-evaluated: artificial intelligence, radiomics and new quantitative methods to report CT and MRI will improve imaging usage.

Automated summary

Multiple myeloma is becoming more common in the elderly population, with bone disease contributing to increased morbidity and mortality. Detecting lytic bone lesions using imaging, such as CT and MRI, is crucial for distinguishing between asymptomatic and symptomatic MM patients. While radiology plays a key role in the staging and management of MM patients, there is still variability in the choice between MRI and CT, as well as suboptimal agreement among readers. The potential of medical imaging in MM is underestimated, and advancements in artificial intelligence, radiomics, and quantitative methods could improve its usage.