PET CT Scan for Multiple Myeloma

Multiple myeloma is a cancer of plasma cells in the bone marrow that damages bones. PET CT can show active myeloma deposits in the whole body, find disease outside the bone, and check whether treatment has worked. It is used together with blood tests, bone marrow tests, and MRI or low-dose whole-body CT.

What Is Myeloma and Why Imaging?

Myeloma cells weaken bones, causing pain, fractures, high calcium, anaemia and kidney problems. Imaging finds bone damage and active disease, which affects staging and treatment. Old skeletal surveys with X-rays miss many lesions, so modern guidelines use low-dose whole-body CT, MRI or PET CT. See what a PET CT scan is.

TestWhat it adds in myelomaBlood and urine tests (M protein, free light chains)Main markers of disease activityBone marrow biopsyConfirms the diagnosis and cell typeLow-dose whole-body CT or X-ray surveyShows bone holes (lytic lesions)MRI spine and pelvisShows marrow involvement and cord pressurePET CTShows active disease and response

How PET CT Helps

• Shows active deposits in the bone marrow and soft tissue (extramedullary disease)
• Helps decide if a single bone lump is a plasmacytoma or part of widespread disease
• Checks treatment response: if activity disappears, it is a good sign
• Finds relapse when blood markers are unclear
• The CT part shows bone holes and fracture risk

Limits and Partners

Some myeloma cells take up little FDG, so a normal PET CT does not rule out disease. Diffuse marrow disease may be missed. MRI shows marrow involvement better, especially in the spine. Steroid treatment can reduce uptake. Your haematologist will combine PET CT with blood tests and other imaging. See PET CT vs MRI.

Preparation

Fast for 4 to 6 hours and keep blood sugar controlled, since steroids used in myeloma can raise sugar. Tell the staff about kidney problems, recent steroids, bone pain and fractures. Drink water unless restricted. Carry blood tests, bone marrow report and MRI reports. See PET CT preparation.

A Practical Example

Dilip, 58, has back pain, anaemia and raised protein in the blood. Bone marrow confirms myeloma. A PET CT shows active deposits in the spine, ribs and pelvis, with a soft tissue lump next to a rib. His haematologist starts combination therapy. After six months, a repeat PET CT shows almost complete disappearance of activity, supporting a deep response.

Care Tips and Key Facts

• Drink fluids to protect the kidneys unless told otherwise
• Avoid strain and heavy lifting if you have weak bones
• Report new bone pain, weakness or numbness quickly
• Keep calcium and vitamin D plans as advised

After the Scan and Next Steps

Take the PET CT report to your haematologist. The scan helps plan treatment, such as chemotherapy, targeted drugs, stem cell transplant or radiotherapy for painful lesions. Bone-strengthening medicines and supportive care protect against fractures. Keep regular follow-up with blood and urine tests.

Questions to Ask Your Doctor

• Do I need PET CT, MRI or low-dose CT at diagnosis?
• Is my disease only in the bone marrow or also outside?
• How will we measure my response?
• Which medicines protect my bones?

Common Mistakes to Avoid

• Ignoring new back pain or leg weakness.
• Taking sugary food before the scan because of steroid hunger.
• Stopping bone-protecting medicine without advice.

Booking, Timing and Report

Ask your doctor for the best timing of the scan. Book a morning slot so that fasting is easier, arrange someone to accompany you, and allow 2 to 3 hours at the centre. Carry biopsy, scan and blood reports and a medicine list. Reports are usually ready within 24 to 48 hours, and images can be given on a CD or digital link for your doctor.

Frequently Asked Questions

Is PET CT used for multiple myeloma?

Yes, to show active disease and response.

Can PET CT replace bone marrow biopsy?

No.

Does MRI have a role?

Yes, especially for spine and marrow disease.

Can some myeloma be missed on PET CT?

Yes, if cells take up little tracer.

Do steroids affect the scan?

They can reduce uptake.

Do I need fasting?

Yes, 4 to 6 hours.

Is it safe with kidney disease?

FDG does not harm the kidneys; the CT usually needs no contrast.

How often is it repeated?

As your haematologist advises.

When is the report ready?

Usually 24 to 48 hours.

Book Your Test at Ganesh Diagnostic

Ganesh Diagnostic & Imaging Centre in Rohini, Delhi offers this test with trained radiology staff and clear reports. You can book an appointment online, check our branches across Delhi NCR, contact us for current rates, or explore all our services. Reports can be downloaded online through our patient portal, so you do not need to make a second trip just to collect them.

This article is for general information only. It does not replace advice from your doctor. Always follow your doctor's instructions for your test.

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