Multiple myeloma is a type of cancer found in bone marrow. It affects the body’s plasma cells, making it difficult for your body to make healthy blood cells. This cancer is sometimes called Kahler’s disease or myelomatosis.
MRIs and other diagnostic tools like lab tests can help detect these growths and can help your doctor confirm a diagnosis of multiple myeloma.
In this article, we’ll overview how an MRI machine works, why it’s an important tool in diagnosing multiple myeloma, and what the process of getting an MRI is usually like.
Magnetic resonance imaging (MRI) uses radio waves and magnetic fields to create detailed images of the inside of your body. MRIs allow doctors to see soft tissues, bones, bone marrow, and areas such as your brain and spinal cord.
MRIs are very helpful in confirming a diagnosis of multiple myeloma. For this purpose, they are better than other imaging tests, such as X-rays or CT scans, at detecting melanoma deposits. Doctors use MRI results to diagnose or rule out multiple myeloma.
MRIs can also be used after beginning cancer treatment to monitor the myelomas, and see whether a treatment approach is working.
Among their other abilities, MRIs can create images that look inside bones. An MRI can show:
Standard X-rays and other imaging tests, like PET scans, are not as sensitive at detecting multiple myeloma bone lesions as MRI.
An MRI can allow doctors to see whether multiple myeloma cell deposits are forming lesions or cancer spots in your bones. MRI can sometimes detect if these myeloma cells are replacing bone marrow, but that is not the primary use of this test.
MRIs are especially good at detecting lesions in the spine, skull, and pelvis. This can help confirm a diagnosis of multiple myeloma. It can also help doctors determine the size of the multiple myeloma tumors and assess the extent of any spread.
The exact procedure for your MRI will depend on the imaging clinic. However, there are some basics you can expect during any MRI test.
You’ll change into a hospital gown and store your belongings in a locker. During the MRI, you won’t be able to wear any:
- hearing aids
- other metals
Fillings, braces, or makeup with any metallic minerals will not be affected.
Let the MRI technician know if you needed to remove any of these items, such as hearing aids or glasses, and if you need any additional help. For example, the technician can guide you if you’re unable to see clearly without your glasses.
You might have contrast fluid injected via an IV to make the MRI images clearer. This is called an “MRI with contrast.” If your doctor has ordered contrast on your MRI images, the MRI technician will insert the IV line before your MRI begins. This may occur after a numbing agent has been injected.
You’ll lie flat on a table that goes into the MRI machine. The machine will have a well-lit tunnel opening. Some facilities have open MRI machines, but most imaging is still done in closed MRIs.
Some people find being inside an MRI machine claustrophobic, stressful, and challenging to get through. Talk with your doctor before your MRI if you’re concerned. They might prescribe medication to help keep you calm during the test. It may help to have a friend or family member come to your appointment for emotional support, too.
The technician will hand you a cord with an alarm button at the end. This will allow you to communicate with the technician at any time during the test.
You’ll need to lie completely still, but you’ll be able to talk with the technician and tell them if you’re in pain, panicked, or need to stop the test for any reason.
The technician will go into another room to operate the MRI. They will be able to see you the entire time through a window.
To be screened for multiple myeloma, you will receive a whole-body MRI, which means your entire body will be inside the machine’s tubular chamber.
You might hear loud noises while inside from the electrical currents and magnet, but headphones or earplugs will mute some of this sound.
The length of the procedure will vary depending on the number of images needed. Full-body MRIs, especially with contrast, often take longer. Your doctor and the technician will let you know exactly how long you will be scanned, and update you as time passes.
After the test, you’ll be free to return to work, school, or your home. You’ll be fine to drive on your own, even if contrast was used, and you won’t need to have any downtime.
However, you won’t be allowed to drive immediately afterward if you were given a sedative to help with claustrophobia or anxiety during the MRI.
Your doctor will contact you with the results once the images have been checked for multiple myeloma growths.
MRIs and tattoos
In rare cases, the MRI’s electrical currents and magnets can cause tattoo ink to heat up. This may cause a warm or “tingling” feeling at the site of the tattoo. In a few documented cases, it has led to burns.
Make sure you inform your doctor and technician of any recent or current tattoos so they can address your concerns.
And remember: You can communicate with a technician to stop the MRI at any time if absolutely necessary.
MRIs are a useful diagnostic tool that are often used to confirm a multiple myeloma diagnosis. However, they’re not the only test you’ll have as part of the diagnosis process.
Other common tests include:
- Lab tests. Blood work is a standard part of the diagnostic process. It’s very likely you’ll have a complete blood cell count (CBC) test done. Myeloma cells in your blood marrow make it difficult for your body to make enough healthy blood cells. A CBC measures the number of white blood cells, red blood cells, and platelets in your blood.
- Biopsy. A biopsy is a test that looks at your bone marrow to see whether there are myeloma cells present. It’s done by inserting a long and hollow needle directly into an affected bone to extract bone marrow or bone marrow fluid.
- Fluorescent in situ hybridization (FISH). A FISH test looks at your chromosomes. It can find chromosomal changes that are linked to multiple myeloma. It’s done by looking at the bone marrow that was extracted during a biopsy.
- X-ray. An X-ray creates detailed images of your bones. It looks for damages to bones caused by multiple myeloma.
- CT scan. A CT scan creates pictures of organs using X-ray images taken from many angles. It looks for damage done by multiple myeloma. It’s also used with biopsies to help guide the needle.
Some people will not have any symptoms, especially early on in disease progression.
If you do have symptoms, these can include:
- bone pain, especially in the skull, back, and ribs
- weak bones, or bones that fracture easily (osteoporosis)
- frequent infections
- bruising easily, or bleeding too much from a cut
- trouble breathing
Your exact treatment plan for multiple myeloma will depend on your cancer stage, how well the cancer responds to treatment, your overall health, and other individual factors. Most treatment plans involve a combination of treatment options.
The following are standard treatments for multiple myeloma:
- Chemotherapy. Chemotherapy uses strong medications to kill cancer cells.
- Targeted therapy. Targeted therapy looks for weaknesses or abnormal behavior in cancer cells. Targeted therapy medications then block those weaknesses or behaviors. This causes cancer cells to die.
- Corticosteroids. Corticosteroid medications help control your immune system and reduce inflammation. They can also help fight myeloma cells.
- Radiation therapy. Radiation therapy uses energy beams to kill cancer cells. In multiple myeloma, it’s often used to shrink growths that are causing bone damage.
- Bone marrow transplants. A bone marrow or stem cell transplant is a procedure that replaces all of your cancerous bone marrow with healthy bone marrow.
- Clinical trials. New treatment options for multiple myeloma are being researched and developed. You can talk with your doctor about clinical trials that could allow you to be among the first people treated with new therapies for multiple myeloma.
An MRI is a test that can create detailed images of the inside bones and show soft tissue with a high level of detail.
MRIs can allow doctors to see your bone marrow to look for signs of multiple myeloma. This makes them the best choice for diagnosing multiple myeloma since X-rays and CT scans are not as effective for this purpose.
However, MRI alone cannot confirm or rule out multiple myeloma. You will definitely need to do blood work and have a tissue biopsy. Your doctor might also schedule an X-ray or CT scan.
Before and during an MRI, it’s important you follow the MRI technician’s directions. Your doctor will call you or schedule an appointment to discuss your results as well.
Getting an MRI can be uncomfortable and stressful for some people. It’s important you communicate any concerns to your doctor, and make sure you have the medication or emotional support you need on the day of your appointment.