[Toni]

Re: How important is a PET scan?

by Toni on Tue Jul 22, 2014 6:46 pm

MultiBilly - I had a chance to think about what you said. PET disproved lytic activity? Wow, who would have guessed!

I am currently reading the articles you quoted and drilling into them more I see that there was a study showing that osteophytes [bone spurs] will erroneously increase bone density on DEXA. I remembered that a year or so ago I was evaluated for hip pain with MRI of the lower spine, lumbar, sacrum ileus and hip joint and the beginnings of degenerative disk, and many osteophytes were noted.

Curious though, all this started when the neurologist ordered evaluation of the lumbar spine due to the pain and neuropathy and they noted degenerative disk disease, which is far more extensive now. But there was no comment of osteophytes.

I have an appointment at the cancer center at Froedert Hospital in Milwaukee on Friday. Perhaps I can bring this up with my new physician and ask him about it.

I wonder if they would do more imaging? Or maybe because my M-spike is low (1.0 g/dL) they will just continue to monitor more with labs.

[Blee]

Re: How important is a PET scan?

by Blee on Tue Jul 22, 2014 7:47 pm

I'm wondering about appropriate imaging for disease progression (I have high risk SMM).
What do you think about yearly (or even sooner) spine and pelvis MRI (whole body not available for me) vs PET/CT? Are your doctors recommending this?

[Multibilly]

Re: How important is a PET scan?

by Multibilly on Tue Jul 22, 2014 10:32 pm

Blee, that's a great question. I think the drawback to using only the MRI for looking at just the pelvis and spine is that it would then miss other common areas where lesions are found (ribs, skull, etc). So, it seems like if you are doing routine scanning and have no reason to suspect a given area of the body, that you would want to do also be doing a full-body xray or a full-body PET/CT.

If you go back and read the IMWG consensus, it also states:

"MRI gives information COMPLEMENTARY to skeletal survey and is recommended in multiple myeloma patients with normal conventional radiography and in all patients with an apparently solitary plasmacytoma of bone. Urgent MRI or CT (if MRI is not available) is the diagnostic procedure of choice to assess suspected cord compression".

In my case, my doc and I are only really talking about full body xray versus full body PET/CT as a routine means to monitor disease progression of my SMM (full body MRI just isn't available in my state).

[goldmine848]

Re: How important is a PET scan?

by goldmine848 on Wed Jul 23, 2014 7:24 am

My understanding is that a skeletal survey can show lesions and can be used to compare the state of one's lesions to prior surveys. A PET/CT with contrast can show if there is active myeloma in the lesions by whether there is FDG uptake.

[Multibilly]

Re: How important is a PET scan?

by Multibilly on Wed Jul 23, 2014 7:54 am

Goldmine,

I think you've got that right. This is one of the reasons that my doc and I aren't talking about doing away with xrays, but rather just substituting a PET/CT into the routine imaging follow-up now and then.

[Wayne K]

Re: How important is a PET scan?

by Wayne K on Wed Jul 23, 2014 9:49 am

Cost is always a factor and X rays are much cheaper to check for noticeable abnormalities. As far as their inability to reveal small tumors, that information in a multiple myeloma patient probably isn't that valuable to any treatment plan.

[Gilbert Siegel]

Re: How important is a PET scan?

by Gilbert Siegel on Wed Jul 23, 2014 7:31 pm

I am non-secretory multiple myeloma. PET scan only way to check my vitals.

Since January 10, 2010, I've had 10 scans every 6 months.

All is well. Thank you Hackensack Medical Center.

Stay Strong

[Beacon Staff]

Re: How important is a PET scan?

by Beacon Staff on Thu Jul 24, 2014 4:54 pm

In response to the question asked at the beginning of this forum thread, Beacon Medical Advisor Dr. Prashant Kapoor has written and posted here in the forum an extended perspective on the role of PET scans in the diagnosis, treatment, and monitoring of myeloma.

You can find Dr. Kapoor's posting here: "To PET or not to PET."