I happen to be getting the standard skeletal surveys which are a poor indicator of disease response. For starters bone lesions don't get smaller if you have a great response. There is some evidence that bone regrowth will occur, but it is a very slow process if it does. I have had a couple bone marrow MRI's done over the course of the past 2 years. They have the added benefit of no ionizing radiation and the potential for accessing bone marrow involvement albeit with low precision. So were do I end up... looking for cutting edge myeloma imaging techniques. There is a group of researchers in Germany working on PET markers for MM. The standard PET marker basically measures glucose uptake which is supposed to be higher in tumors than healthy tissue. The trick with PET markers is to find one that is specific to what you want to image and has sufficient uptake that the scanner can actually see it. I think there is an imaging question for a bunch of mechanical engineers to be had here. Hee hee hee. If you cut through the big words it boils down to is there enough "light" and is everything else dark. Another group from Cambridge, UK, has developed an exciting imaging technique called magnetic resonance spectroscopy (MRS) which is specific to changes in lactate dehydrogenase (LDH). MMer's know all about LDH. I get mine tested twice a week during this clinical trial. A change in LDH level in myeloma cells can be correlated with the amount of cell death and can therefore provide very early feedback of the efficacy of a particular therapy.
Nobody wants to keep taking a drug that isn't working. I sure would like to know if what I am taking is working! I'll let you know tomorrow. :-)