Your doctor will usually arrange for x-rays to check your bones, and may suggest other imaging scans, such as a CT or MRI.
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Bone x-rays, sometimes called a skeletal survey, are used to find any bone damage caused by the myeloma cells. X-rays are usually taken of your head, spine, ribs, hips, legs and arms. Areas of bone damage, known as lytic lesions, show up on x-ray film as black shaded areas.
Skeletal surveys are sometimes done using traditional x-rays. However, you will usually have access to the more accurate CT (computerised tomography) skeletal survey. Ask which option will be available to you at your hospital or medical imaging centre. For the CT scan, you lie flat on a table while the scanner takes detailed pictures of your body. The scan takes about 30 minutes.
An MRI (magnetic resonance imaging) scan can find myeloma both inside and outside the bones. It uses magnetic fields and radio waves to take detailed cross-sectional pictures of the body. Let your doctor know if you have a pacemaker as the magnetic waves may interfere with it, though newer models do not have this problem.
For an MRI, you will lie on a table that slides into a large machine shaped like a cylinder. The scan may take 30–40 minutes. It is painless but can be noisy. You will be offered earplugs or headphones to listen to music. Some people feel anxious or claustrophobic in the cylinder. If you think you may feel distressed, let your medical team know before the appointment. You may be offered a mild sedative to help you relax.
Dye injection for CT or MRI
CT and MRI scans of organs sometimes involve the inject a dye (contrast) into a vein, usually in your arm. This dye makes the pictures clearer.
Before having scans, tell the person doing the scan that you are suspected of having myeloma, as this dye can damage the kidneys and may not be safe for you.
Also, let the medical team know if you have any allergies, if you have had a reaction to contrast during previous scans, if you have diabetes or if you could be pregnant. Skeletal surveys usually don’t need any contrast to be injected.
In some cases, your doctor may arrange specialised scans, such as a PET–CT (positron emission tomography–computed tomography) or sestamibi (MIBI) scan. Both of these scans involve an injection of a small amount of a harmless radioactive substance, which shows up areas of healthy and abnormal tissue. This may help detect myeloma outside of the bone marrow. Most people with myeloma do not need to have these scans.
Podcast: Tests and Cancer
Dr Ian Bilmon, Haematologist, Westmead Hospital and The Sydney Adventist Hospital; Martin Boling, Consumer; Catherine Bowley, Myeloma Support Nurse, Myeloma Australia; Dr Samuel Dickson, Radiation Oncologist, Calvary Mater Newcastle; Rachelle Frith, Clinical Nurse Consultant, Haematology, Prince of Wales Hospital; Dr Wojt Janowski, Haematologist, Calvary Mater Newcastle; Yvonne King, 13 11 20 Consultant, Cancer Council NSW.
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