[gardengirl]

Complete spine MRI as part of work-up?

by gardengirl on Wed Apr 02, 2014 6:00 pm

Hi All, I'm just wondering how many of you have had a complete spine MRI as part of your work-up. Is it standard for smoldering myeloma? I ask this because if you do not exhibit any CRAB symptoms and there is "something" on the spinal MRI, it may be considered stage 1...changing everything! (I know I have posted similar topics about this, but never asked how often this is done!) Thank you!!!

[Multibilly]

Re: Complete spine MRI as part of work-up?

by Multibilly on Wed Apr 02, 2014 9:07 pm

I had a PET/CT done as a SMM patient and I believe it (or a full body MRI) should be done as a matter of course with smoldering myeloma from time to time. But I wouldn't call this SOP in the medical industry for smoldering myeloma, since it seems that only Xray surveys are currently called for by the NCCN wrt ongoing SMM monitoring (although this x-ray only approach for imaging is currently being re-evaluated by the NCCN).

I would be worried about only looking at one's spine and not the rest of one's skeleton with an MRI, unless an x-ray survey had previously shown something suspicious in one's spine.

[Dr. Edward Libby]

Re: Complete spine MRI as part of work-up?

by Dr. Edward Libby on Thu Apr 03, 2014 1:09 pm

Hello gardengirl,

There have been a number of publications on the topic of smoldering myeloma (SMM) in the past year. These research studies and opinions do not all agree with each other (no surprise!). Because of this, the standard recommendations for diagnosis and treatment of SMM have become a moving target.

A "bone marrow" MRI is not standard, but would be very reasonable for patients with smoldering myeloma. Patients with "high risk" SMM may especially benefit from a bone marrow MRI. The definition of "high risk" SMM is not clearly established however. A skeletal survey is standard for SMM; the use of PET/CT in myeloma and SMM not as well as that of MRI.