الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Conventional radiography was the baseline diagnostic evaluation to detect osteolytic bone lesions of the entire skeleton. Despite low costs and wide availability, conventional radiographic surveys have profound disadvantages such as relatively high false-negative rates and lack of bone marrow evaluation which make this technology less suitable for early diagnosing, staging, evaluating multiple myeloma. CT overcomes problems as low anatomic resolution particularly in complex body regions and the newly developed whole-body technology allows examination of the whole body to diagnose spread of the disease in the axial and peripheral skeleton. Converse to conventional radiography, the radiation dose is much higher. Therefore, whole-body LDCT was introduced. Despite lower radiation doses, given a high-enough resolution of the CT scan the sensitivity for detecting osteolytic foci and determining overall stage is still much higher than in simple radiographic technologies. In addition, it can differentiate between benign and malignant vertebral compression fractures; detect extraosseous lesions as well as intramedullary hyper-attenuating bone marrow lesions. MRI has superior sensitivity for detection of both focal and diffuse pattern of bone marrow involvement and will result in upstaging of multiple myeloma with the advantage of lacking ionizing radiation. Moreover, MRI has prognostic significance; the number and pattern of enhancement of lesions on MRI correlates very well with treatment outcome. PET/CT combines the high sensitivity of PET with high spatial resolution (anatomy) of CT, which provides ideal screening technology for multiple myeloma since PET uptake indicates active myeloma and CT shows bone destruction. It is more sensitive than MRI to differentiate between treated bone marrow lesions and viable neoplastic tissues. As regarding facilities in our university hospitals we recommend WBLD-MDCT for initial staging then the patient can be followed up using MRI to monitor effect of treatment.