Do you perform a periodic PET CT to screen for extramedullary disease in patients with MM who are in remission?

This is an excellent question with guidelines and inferences from clinical trials, but admittedly, no randomized data showing that surveillance PETs improve outcomes versus as-needed PETs. To start, here's what NCCN guidelines recommend for patients in surveillance/on maintenance therapy alone: "Who...

No, I don’t. The odds of finding presymptomatic EMD on a yearly scan are low and not cost-effective. We have learned in other diseases where it has been studied in clinical trials (lymphoma, breast, lung), that surveillance scans do not change outcomes. As far as I can tell, the only diseases that b...