Multiple myeloma is a disease characterized by the proliferation of plasma cells which can lead to the abnormally high production of monoclonal immunoglobulins, detected in serum and urine. These plasma cells can enter the bone marrow and replace normal myelopoiesis. Up to 90% of patients progress to bone disease, and for this reason effective imaging is an important management technique in multiple myeloma patients.
Conventional radiography
Conventional radiography is the commonly used standard for diagnosis and tracking of multiple myeloma. It is currently the recommended method for most patients, and often a full conventional radiographic examination is advised for patients who have recently been diagnosed. Of these, almost 80% of patients display noticeable changes on conventional radiography.
Conventional radiography is highly effective relatively, compared to other technologies as stated, and has other advantages, too. It is widely available in many clinics and is not expensive. Furthermore, radiography can cover almost the entire skeletal system.
On the other hand, conventional radiography has low sensitivity. Lytic lesions of the bone are only picked up if over 30% of the trabecular bone is destroyed, which could mean many bone lesions go undetected. Extraosseous lesions are also often missed.
Conventional radiography is less frequently recommended for use in diagnosing and tracking multiple myeloma, due to the increased efficiency of other methods such as computed tomography and magnetic resonance imaging.