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Imaging in myeloma: a Royal College of Radiologists national survey of current imaging practice

Research output: Contribution to journalArticlepeer-review

Olwen Westerland, Karl Drinkwater, Jyoti Parikh, Matthew Streetly, Guy Pratt, Vicky Goh, David Howlett

Original languageEnglish
Pages (from-to)820-828
Number of pages9
JournalClinical Radiology
Issue number11
Early online date26 Jun 2021
Accepted/In press20 May 2021
E-pub ahead of print26 Jun 2021
PublishedNov 2021

Bibliographical note

Funding Information: This work was undertaken on behalf of The Royal College of Radiologists (RCR) Clinical Audit and Quality Improvement Committee. The authors would like to thank the following organisations/individuals for supporting this project; participating RCR audit leads, Radiology Academic Network for Trainees (RADIANT), British Society of Haematology Imaging Practice Guidelines Working Group, British Society of Skeletal Radiologists (BSSR), Myeloma UK (MUK), UK Myeloma Forum (UKMF) and Dr Ashik Amlani (GSTT), who retrieved a number of the images. Publisher Copyright: © 2021 The Royal College of Radiologists Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Aims: To evaluate current national imaging practice in myeloma with reference to National Institute for Health and Care Excellence (NICE) guidelines (NG35, 2016) and compare results with an initial survey conducted in 2017 (61 participating sites). Materials and methods: All UK radiology departments treating myeloma patients and with a Royal College of Radiologists (RCR) Audit Lead were invited to participate. Data were collected using an online questionnaire. Descriptive statistics were performed. Results: One hundred and fourteen hospitals supplied data (54% return rate). Skeletal survey (SS) remains the most-commonly performed first-line imaging test for suspected/confirmed myeloma or plasmacytoma (39%, 45/114 hospitals), followed by whole-body magnetic resonance imaging (WBMRI) (27%, 31/114) and whole-body computed tomography (WBCT) (19%, 22/114). Integrated positron-emission tomography/CT (PET/CT) was first-line in 14% (16/114). The NICE recommended initial investigation, WBMRI, is currently offered in 27% of surveyed hospitals (<10% in 2017). Ongoing challenges to implementing WBMRI include scanner availability, financial constraints, reporting time, and radiologist training. Conclusion: Despite NICE recommendations regarding WBMRI in diagnosis/follow-up of myeloma, SS (poor sensitivity and specificity) remains the most commonly performed first-line test. Radiologists, haematologists, and patients should continue to emphasise the superiority and benefit of modern and more accurate imaging, such that they are prioritised in clinical service planning.

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