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 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.
A CT (computerised tomography) scan uses x-rays and a computer to make detailed pictures of the inside of your body. It can find bone damage that may not show up on a standard x-ray.
For a CT scan, you will lie flat on a table while the scanner, which is large and round like a doughnut, takes pictures. The scan takes about 30 minutes, and most people can go home straight after.
An MRI (magnetic resonance imaging) scan can sometimes find myeloma both inside and outside the bones. It uses magnetic waves to create detailed cross-sectional pictures of areas inside the body. You should let your medical team know if you have a pacemaker, as the magnetic waves can interfere with some pacemakers.
For an MRI, you will lie on an examination table inside a large metal tube that is open at both ends. The noisy, narrow machine makes some people feel anxious or claustrophobic. If you think you may become distressed, mention it beforehand to your medical team. You may be given a mild sedative to help you relax, or you might be able to have a family member or friend in the room with you for support. You will usually be offered headphones or earplugs, and you may be able to bring along your favourite music to play. The MRI scan may take between 30 and 90 minutes.
Dye injection for CT or MRI
CT and MRI scans of organs sometimes involve the injection of a dye (contrast) into a vein, probably in your arm. This dye makes the pictures clearer. Before having scans, let the person doing the scan know 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 or have had a reaction to contrast during previous scans, are diabetic or are pregnant. Scans of bones usually do not need any contrast to be injected.
In particular cases, your doctor may arrange specialised scans, such as an FDG-PET (fluorodeoxyglucose positron emission tomography) or sestamibi scan. Both of these scans involve an injection of a small amount of radioactive substance, which shows up areas of healthy and abnormal tissue and may help detect myeloma outside of the bone marrow. Most people with myeloma do not need these scans.
Dr Jane Estell, Senior Staff Specialist, Haematology Department, Concord Cancer Centre, and Senior Clinical Lecturer, The University of Sydney; Brenda Clasquin, 13 11 20 Consultant, Cancer Council NSW; Jacqui Keogh, Senior Myeloma Support Nurse, Myeloma Australia; Dr Silvia Ling, Haematologist, Liverpool Hospital and Sydney Adventist Hospital; and John Miller, Consumer.
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