National myeloma patient survey shows continuing inappropriate imaging and geographical inequalities.

ABSTRACT

OBJECTIVE: To evaluate the provision of imaging at diagnosis of myeloma from the service user perspective with a specific focus on how the experiences of patients align with The National Institute for Health and Care Excellence (NICE) guidelines (NG35, 2016) on first-line imaging practice for myeloma in the UK. METHODS: We performed a national survey to evaluate access to imaging from the patient's perspective. Patients with myeloma who received their diagnosis between 2017 and March 2022 were invited to participate. Data were collected using an online survey from 895 patients and carers between 4 and 14 March 2022. RESULTS: Most patients had more than one imaging test. First-line MRI was used in 48.7% of respondents. First-line skeletal survey (SS, whole body X-rays) remained common (48.7% of respondents). 18F-fluorodexyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was used least often (23.1% of respondents). SS was used more often in East England (57.9%) and Scotland (61.2%) than in South East England (36.3%). CONCLUSIONS: Despite NICE recommendations, first-line MRI was not used in a third of patients surveyed, with geographical variation in imaging practice and patients are still undergoing multiple imaging tests at diagnosis. Healthcare professionals should continue to emphasise the superiority of MRI compared to SS to drive for improvements in care. ADVANCES IN KNOWLEDGE Current recommendations on first-line imaging in the UK for myeloma is not consistently provided across the UK. There is a need to drive change and support healthcare professionals to deliver guidance-based recommendations to improve outcomes for myeloma patients.