Avoid whole-body MRI in patients with mild to severe frailty (Clinical Frailty Scale, CFS 5–9) with smouldering multiple myeloma

Rationale:

Advanced imaging in this patient group often yields findings that do not affect treatment or follow-up and may lead to overdiagnosis. MRI examinations are resource-intensive, may be uncomfortable for the patient, and can cause unnecessary distress due to inconclusive findings.  

References: 

• Rajkumar SV, Dimopoulos MA, Palumbo A, mfl. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. The Lancet Oncology. 2014
• American Society of Clinical Oncology. Palliative care for patients with cancer: ASCO guideline update. Journal of Clinical Oncology. 2024