Precision medicine in myeloma demands precision imaging: is whole body MRI the solution?

Outcomes for patients with multiple myeloma have improved substantially over the past two decades, with median overall survival more than doubling in many cohorts. Management of smouldering myeloma has also shifted, with randomised trials demonstrating that early intervention in high-risk disease delays progression and improves survival compared with observation alone. Imaging diagnostics must therefore evolve in parallel to provide minimally invasive, sensitive and quantitative insights into disease for patients who will live with myeloma for many years. Here we review the latest evidence for WB-MRI in myeloma, outline current guideline recommendations, and consider future directions.