Precision medicine in myeloma demands precision imaging: is whole body MRI the solution?

TL;DR

This paper discusses the importance of advanced imaging, like whole body MRI, in improving the management of multiple myeloma as treatment outcomes improve.

Contribution

The paper reviews the latest evidence and guidelines for whole body MRI in myeloma and suggests future directions for its use.

Findings

Median overall survival for myeloma patients has more than doubled in recent years.

Early intervention in high-risk smouldering myeloma improves survival compared to observation.

Whole body MRI is proposed as a sensitive and quantitative imaging tool for long-term disease monitoring.

Abstract

Outcomes for patients with multiple myeloma have improved substantially over the past two decades, with median overall survival more than doubling in many cohorts. Management of smouldering myeloma has also shifted, with randomised trials demonstrating that early intervention in high-risk disease delays progression and improves survival compared with observation alone. Imaging diagnostics must therefore evolve in parallel to provide minimally invasive, sensitive and quantitative insights into disease for patients who will live with myeloma for many years. Here we review the latest evidence for WB-MRI in myeloma, outline current guideline recommendations, and consider future directions.