Liquid Biopsy Significance 7/10

IMWG Consensus Standardises Imaging for Bone Disease and MRD Detection in Myeloma

The International Myeloma Working Group established imaging guidelines for monoclonal plasma cell disorders, recommending low-dose whole-body CT over conventional skeletal survey for bone disease detection, and defining roles for PET/CT and MRI across disease stages. The consensus addresses imaging-based MRD assessment, standardising methods for detecting residual disease that complements flow cytometric and molecular MRD evaluation.

The original study

International myeloma working group consensus recommendations on imaging in monoclonal plasma cell disorders.

Authors
Hillengass J, Usmani S, Rajkumar SV, Durie BGM, Mateos MV, Lonial S, et al.
Journal
The Lancet. Oncology
Type
Journal Article, Research Support, Non-U.S. Gov't, Review, Consensus Statement
PMID
31162104
Read the original study →

Original abstract

Recent advances in the treatment of multiple myeloma have increased the need for accurate diagnosis of the disease. The detection of bone and bone marrow lesions is crucial in the investigation of multiple myeloma and often dictates the decision to start treatment. Furthermore, detection of minimal residual disease is important for prognosis determination and treatment planning, and it has underscored an unmet need for sensitive imaging methods that accurately assess patient response to multiple myeloma treatment. Low-dose whole-body CT has increased sensitivity compared with conventional skeletal survey in the detection of bone disease, which can reveal information leading to changes in therapy and disease management that could prevent or delay the onset of clinically significant morbidity and mortality as a result of skeletal-related events. Given the multiple options available for the detection of bone and bone marrow lesions, ranging from conventional skeletal survey to whole-body CT, PET/CT, and MRI, the International Myeloma Working Group decided to establish guidelines on optimal use of imaging methods at different disease stages. These recommendations on imaging within and outside of clinical trials will help standardise imaging for monoclonal plasma cell disorders worldwide to allow the comparison of results and the unification of treatment approaches for multiple myeloma.