PET-CT for — Multiple Myeloma

Yes, for staging and response assessment, PET-CT is now recommended by IMWG and NCCN guidelines, replacing the skeletal survey. Availability varies across centres, but PET-CT is accessible at most larger oncology hospitals in Telangana and Andhra Pradesh. Where a scanner is not on site, scans are coordinated with partner imaging centres. MRI is also recommended in guidelines, and some teams use both depending on the clinical question.

PET-CT shows metabolic activity — it finds lesions that are actively consuming glucose, and is the better scan for detecting extramedullary disease and assessing treatment response. MRI shows anatomy in greater detail and is better at detecting diffuse marrow infiltration and spinal cord involvement. IMWG recommends both as superior to the skeletal survey. Your team will use one or both depending on what they need to know at each stage of your treatment.

FDG-avid means the lesion is taking up fluorodeoxyglucose — the radiotracer used in PET scanning — which indicates that the cells there are metabolically active. In myeloma, this typically means active disease. A lesion described as no longer FDG-avid after treatment has stopped consuming the tracer, which is one sign that the treatment is working. Your haemato-oncologist will interpret this alongside your blood results and other findings.

Complete metabolic response — abbreviated CMR in reports — means that no FDG-avid lesions are visible on the scan after treatment. It is one of the imaging-based response milestones that IMWG includes in its criteria for assessing how well myeloma treatment has worked. Achieving CMR is a positive finding, but your haemato-oncologist will interpret it alongside bone marrow results, protein levels in your blood and urine, and your overall clinical picture.

No. They answer different questions. The biopsy tells your team how many myeloma cells are in the marrow, what they look like, and what genetic changes they carry — information that imaging cannot provide. PET-CT shows where in the body disease is active and how metabolically intense it is. Both are part of the assessment, and one does not replace the other. Your team will decide which tests are needed at each point in your diagnosis or treatment.

SUV values measure how much radiotracer each lesion absorbed. They are recorded so your haemato-oncologist can track whether individual lesions increase or decrease over time and across scans. You do not need to look up what a specific number means or compare it with someone else's — the interpretation depends on your baseline, the location of the lesion, and the full clinical picture. Bring the report to your next appointment and ask your team to walk you through the findings.