Purpose of review: Multiple myeloma is a common hematological malignancy arising in the bone marrow. Bone lesions were initially depicted with conventional radiography, although recently F-FDG PET/CT and MRI are recognized as having a clear role in the initial workup and in the evaluation of therapy response.
Recent findings: Tumor development produces osteolysis and expansive lesions. Although tumor burden and extent are key prognostic factors, different cancer hallmarks can also be evaluated in vivo through noninvasive imaging.
Summary: This imaging-based virtual biopsy approach might be useful to define several relevant prognostic markers, such as angiogenesis, cellularity, metabolic trapping and bone morphology and elasticity, both before and during treatment, to predict tumor behavior and the early effect of therapy.