The article reviews the current and future imaging techniques for multiple myeloma (MM), focusing on low-dose whole-body CT (LDWBCT), dual-energy CT (DECT), magnetic resonance imaging (MRI), and FDG-PET/CT. MM is the second most common adult hematologic malignancy, with early diagnosis improving survival. Imaging is crucial for diagnosis and follow-up, as bone and bone marrow lesions dictate treatment decisions. LDWBCT is the initial modality, while DECT enhances detection of non-lytic marrow infiltration. MRI is more sensitive than FDG-PET/CT for small lesions and diffuse infiltration, but FDG-PET/CT is preferred for follow-up. Diffusion-weighted MRI (DWI) is used for quantitative assessment. Structured reporting is recommended to standardize imaging. LDWBCT is essential for detecting lytic lesions in high-risk MGUS, SMM, and MM. If LDWBCT is positive, FDG-PET/CT is performed; otherwise, no imaging is needed. For SMM and MM with negative LDWBCT, WBMRI is recommended. FDG-PET/CT can replace LDWBCT and WBMRI. Follow-up must use the same technique for comparability. In suspected relapse, LDWBCT assesses bone destruction. FDG-PET/CT is preferred for extramedullary lesions. DECT improves bone marrow assessment by creating postprocessed images with three-material decomposition (calcium, water, fat). VNCa images differentiate fatty marrow from other components. DECT is more sensitive than conventional CT for detecting bone involvement. It also allows quantitative assessment of marrow composition. However, DECT cannot distinguish between marrow infiltration and hematopoietic marrow conversion. VNCa images are useful for quantitative assessment of focal lesions. WBMRI is recommended for patients with negative LDWBCT or FDG-PET/CT findings. It is highly sensitive for detecting bone marrow infiltration, especially before osteolytic lesions. MRI is the most sensitive and specific for detecting bone marrow infiltration. DWI is used for quantitative assessment of disease burden and treatment response. ADC values correlate with cell density and viability, aiding in response assessment. MRI is also useful for assessing spinal complications and differentiating benign from malignant vertebral fractures. FDG-PET/CT is the preferred modality for assessing treatment response. It distinguishes active from inactive disease and provides precise anatomic characterization. SUV values are used to assess response. FDG-PET/CT is more sensitive than MRI for detecting treatment response. However, MRI is also valid for assessing treatment response, though it takes longer for lesions to disappear. FDG-PET/MRI is an emerging hybrid technique combining PET and MRI. It offers high sensitivity for morphology, cellularity, vascularization, and metabolic activity. However, it is not widely implemented and not included in clinical guidelines. FDG-PET/CT is preferred forThe article reviews the current and future imaging techniques for multiple myeloma (MM), focusing on low-dose whole-body CT (LDWBCT), dual-energy CT (DECT), magnetic resonance imaging (MRI), and FDG-PET/CT. MM is the second most common adult hematologic malignancy, with early diagnosis improving survival. Imaging is crucial for diagnosis and follow-up, as bone and bone marrow lesions dictate treatment decisions. LDWBCT is the initial modality, while DECT enhances detection of non-lytic marrow infiltration. MRI is more sensitive than FDG-PET/CT for small lesions and diffuse infiltration, but FDG-PET/CT is preferred for follow-up. Diffusion-weighted MRI (DWI) is used for quantitative assessment. Structured reporting is recommended to standardize imaging. LDWBCT is essential for detecting lytic lesions in high-risk MGUS, SMM, and MM. If LDWBCT is positive, FDG-PET/CT is performed; otherwise, no imaging is needed. For SMM and MM with negative LDWBCT, WBMRI is recommended. FDG-PET/CT can replace LDWBCT and WBMRI. Follow-up must use the same technique for comparability. In suspected relapse, LDWBCT assesses bone destruction. FDG-PET/CT is preferred for extramedullary lesions. DECT improves bone marrow assessment by creating postprocessed images with three-material decomposition (calcium, water, fat). VNCa images differentiate fatty marrow from other components. DECT is more sensitive than conventional CT for detecting bone involvement. It also allows quantitative assessment of marrow composition. However, DECT cannot distinguish between marrow infiltration and hematopoietic marrow conversion. VNCa images are useful for quantitative assessment of focal lesions. WBMRI is recommended for patients with negative LDWBCT or FDG-PET/CT findings. It is highly sensitive for detecting bone marrow infiltration, especially before osteolytic lesions. MRI is the most sensitive and specific for detecting bone marrow infiltration. DWI is used for quantitative assessment of disease burden and treatment response. ADC values correlate with cell density and viability, aiding in response assessment. MRI is also useful for assessing spinal complications and differentiating benign from malignant vertebral fractures. FDG-PET/CT is the preferred modality for assessing treatment response. It distinguishes active from inactive disease and provides precise anatomic characterization. SUV values are used to assess response. FDG-PET/CT is more sensitive than MRI for detecting treatment response. However, MRI is also valid for assessing treatment response, though it takes longer for lesions to disappear. FDG-PET/MRI is an emerging hybrid technique combining PET and MRI. It offers high sensitivity for morphology, cellularity, vascularization, and metabolic activity. However, it is not widely implemented and not included in clinical guidelines. FDG-PET/CT is preferred for