PET/MRI with 18F-FDG helpful in the diagnosis of chronic pain

PET/MRI examination helpful in determining the place in which chronic pain was started

An innovative PET/MRI imaging technique with 18F-FDG can help in the diagnosis of chronic pain. This could bring relief to millions of patients living with chronic pain.

Researchers at Stanford University point out that chronic pain is often caused by tissue inflammation. They are highly metabolic and therefore have the potential to capture the glucose contained in the radiopharmaceutical used for PET imaging – 18F-FDG (fluorodeoxyglucose). A group of scientists tried to determine where pain in the body comes from. For this purpose, anatomical information from MRI was simultaneously analyzed with molecular information from PET.

65 patients with chronic pain who underwent PET/MRI of the whole body were examined. Using special software, Biswal et al. measured the maximized standard uptake values (SUVmax) on 18F-FDG images. In addition, the obtained results were evaluated by 2 radiologists in terms of SUVmax correlation with pain areas.

The obtained results are promising, in 58 out of 65 patients (89%), the researchers found an increased uptake of 18F-FDG in the nerves and muscles at the place of pain, which in turn influenced the change or modification of the therapeutic procedure. The conducted research gives a new tool for doctors and patients in the diagnosis of pain.

More information about the report in the following article:

On picture above is an adult male suffering from chronic pain. Images show abnormally elevated 18F-FDG uptake (white arrows; SUVmax = 1.2) observed in a linear pattern in the space in the posterolateral right neck, between the head of the inferior oblique muscle and the hemispheric muscle of the head, where the greater occipital nerve is located. For comparison, the same area on the opposite, asymptomatic side of the neck has SUVmax = 0.7. After reviewing the PET/MR scan, the surgeon found a collection of small arteries wrapped around the nerve at this location. Small arteries were lysed and the patient reported significant pain relief. Photo courtesy of Peter Cipriano of Stanford University; description courtesy of SNMMI.

As reported by Biswal, the study suggests that the combination of PET/MRI with 18F-FDG may be an effective diagnostic tool for locating a potential place of chronic pain. It can be an effective way to obtain relief for patients who experience chronic pain.