Imaging in plasma cell disorders-consensus recommendations of the Asian myeloma network bone imaging workgroup

Abstract

The role of imaging in accurate classification and management of plasma cell disorders is substantial with the increasing evidence in the ability of cross-sectional imaging to identify disease related manifestations. International myeloma working group and nation-wide guidelines provide recommendations for guiding practice. However, there are remarkable variations in practice globally and in particular, adoption of incorrect imaging techniques due to lack of awareness/education, lack of equipment or personnel and resource constraints. These limitations are not specific to any particular geographic area. Hence in this complex and evolving imaging landscape, clinicians require practical guidance incorporating up-to-date and emerging evidence that is relevant to their healthcare system. In this manuscript we describe the two-pronged (minimum and enhanced) recommendations for imaging in different categories of plasma cell disorders from the Asian myeloma network bone imaging workgroup arrived through a questionnaire-based inquiry of prevailing imaging practices, discussion of those practices in the light of optimal evidence-based imaging recommendations, barriers in adoption of those recommendations and suggestions to overcome some of these barriers. There is an important role for these regionally relevant but globally applicable recommendations rooted in clinical practice which can serve as a medium for Physician/nursing, patient/carer education and to enable dialogue with healthcare technology appraisers/funders and secure interventions required to optimise practice in this field.

Keywords: Bone disease; Bone imaging; Multiple myeloma; Plasma cell disorders; Smouldering myeloma.