Dr. Jens Hillengass, Chief of Myeloma at Roswell Park Comprehensive Cancer Center (Buffalo, NY), led the International Myeloma Working Group (IMWG) to organize new guidelines for imaging techniques to be more accurate when diagnosing myeloma patients, as well as other plasma-cell disorders.
New treatment and drug strategies are significantly improving each year. These guidelines are the first of its kind in over a decade.
“Use of newer imaging techniques is changing the whole landscape, from diagnosis to treatment to supportive care to survivorship, and all those things are coming into this direction of research in multiple myeloma right now,” –Jens Hillengass, MD
The updated imaging guidelines are derived from examining results of computed tomography (CT) and X-ray from several countries. Dr. Hillengass and his team discovered that “using only conventional X-ray misses 25% of instances where patients have bone destruction already”, and therefore need immediate treatment and attention.
The major addition in the new guidelines is the use of whole-body low-dose CT instead of conventional skeletal survey as the standard for assessing bone destruction. In addition, the team recommends PET-CT (positron emission tomography) and MRI (magnetic resonance imaging) to be included in general clinical practices.
“There has to be destruction of 30 to 50% of the bone, sometimes up to 70%, before you see anything on X-ray,” says Hillengass. “More sophisticated imaging is necessary not only in the beginning to assess the disease but also to assess the response and to see what is left after our standard treatment. Myeloma is a disease that can cause focal and diffuse destruction of the bone, and to see that, you need sharp imaging.”
Dr. Hillengass hopes that the implication of these new techniques will lead to “more refined imaging, more accurate diagnoses, earlier treatments and more patients living longer due to lasting remissions.”