Multiple Myeloma

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The Role of Imaging in Multiple Myeloma

Dr. Jens Hillengass Roswell Park Comprehensive Cancer Center

There are a number of different ways doctors determine how myeloma is affecting your body.  One frequent problem they look for is how myeloma causes bone damage, and this requires imaging.

“We have bone eating cells and bone producing cells and they are kind of in a balance,”  says Dr. Jens Hillengass, Chief of Myeloma at Roswell Park Comprehensive Cancer Center. Myeloma causes “the myeloma causes an imbalance.” The cancerous cells release proteins in the bone marrow that reverse the normal process. The proteins produced by the myeloma activate cells in the body dedicated to breaking down bone cells while simultaneously deactivating cells in the body dedicated to building up bones. This disruption can cause pain and small fractures or holes in our bones. So how do doctors detect these bone problems?

CT scans: While there are various ways to detect bone fractures, Dr. Hillengass’s “preferred choice is whole-body low dose CT–computed tomography.” In CT scans, X-rays are sent around the body rather than through it, creating a three-dimensional image of the skeleton that helps doctors determine how much damage the myeloma has caused.

In addition to bone changes the disease resides in the bone marrow, where cancerous plasma cells crowd out other functioning blood and immune cells to form tumors. For this a different kind of imaging is used.

MRI or PET scans: magnetic resonance imaging, or MRI, and positron emission tomography scans, or PET scans, use sophisticated methods to detect changes in the blood flow or cellular makeup in the bone marrow. This can give a sense of how large tumors have grown in the bone marrow.

Together, these imaging techniques can give an accurate sense of the stage of progression of the disease during diagnostic testing.

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Dr. Jens Hillengass is the Chief of Myeloma and a Professor of Oncology at Roswell Park Comprehensive Cancer Center. Read More