Novel PET/MR Imaging Approach for Persistent Postsurgical Pain Following Joint Replacement

用于治疗关节置换术后持续疼痛的新型 PET/MR 成像方法

• 批准号: 10401474
• 负责人: SANDIP BISWAL
• 金额: $ 60.84万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-05 至 2022-10-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10401474
• 关键词: Address; Analgesics; Area; Arthralgia; Awareness; Classification; Clinical; Custom; Detection; Development; Diagnosis; Diagnostic Imaging; Diagnostic Procedure; Early Diagnosis; Early identification; Early treatment; Effectiveness; Evaluation; Fatty acid glycerol esters; Functional disorder; Future; Heating; Hip Joint; Hip Prosthesis; Hip region structure; Image; Impairment; Implant; Inflammation; Inflammatory; Intervention; Investigation; Joint Prosthesis; Lesion; Magnetic Resonance Imaging; Measurement; Medical; Metabolic; Metals; Methods; Morphologic artifacts; Morphology; Orthopedic Surgery; Outcome; PET/CT scan; Pain; Pain management; Pathology; Patients; Persistent pain; Physiologic pulse; Positioning Attribute; Positron-Emission Tomography; Postoperative Complications; Postoperative Pain; Procedures; Prosthesis; Protocols documentation; Quality of life; Radiation; Radiology Specialty; Replacement Arthroplasty; Research Personnel; Resolution; Risk; Roentgen Rays; Scanning; Site; Source; Surveys; Syndrome; Techniques; Time; Tracer; Training; Validation; Water; X-Ray Medical Imaging; attenuation; base; chronic pain; diagnostic strategy; diagnostic tool; effective therapy; experience; fluorodeoxyglucose; fluorodeoxyglucose positron emission tomography; hip replacement arthroplasty; imaging approach; imaging modality; improved; innovation; machine learning method; metallicity; novel; novel diagnostics; pain score; pain sensitivity; pain symptom; soft tissue; success; uptake; validation studies

Project Abstract Overview: This project aims to develop a reliable 18F-fluorodeoxyglucose (18F-FDG) PET/MRI method with novel metal artifact correction techniques to provide early identification of prosthetic complications causing persistent postsurgical pain (PPSP) following total hip arthroplasty (THA). Relevance: THA is one of the most rapidly growing procedures to treat the end-stage hip joint pain and dysfunction, and its annual cases are estimated to reach 572,000 by 2030. Unfortunately, a substantial number of patients experience PPSP after the procedure, which, without proper treatment, can significantly impair the quality of life. However, the early identification of pain generators for these patients is very difficult because the current diagnostic methods including X-ray, CT, and MRI, have limited sensitivity to pain and suffer from severe artifacts induced by metal in prostheses. Therefore, there is a pressing need for a novel diagnostic approach to accurately identify the abnormal inflammatory changes causing persistent pain to guide the appropriate treatment matched to the exact sources of pain. Approach: We propose the use of 18F-FDG PET/MRI for early identification of sources of PPSP following THA. Our previous 18F-FDG PET/MRI study of chronic pain syndromes demonstrated promising improvements in detecting sites of painful inflammation. However, the severe metal artifacts near metallic prostheses limit the application of 18F-FDG PET/MRI to THA patients. Therefore, our first aim in this project is the development of metal-aware attenuation correction for PET to enable reliable 18F-FDG PET near the metallic prosthesis. Our second aim is the development of high-resolution hip MRI at 3T with metal artifact correction to improve our ability for identifying structural causes of PPSP symptoms. Our third aim is to validate the improvements by 18F- FDG PET/MRI in detection of the pain generators compared to PET/CT and conventional MRI. This will be accomplished by correlating the pain score measurements with 18F-FDG PET/MRI abnormalities at 6 months, 12 months, and 18 months following the unilateral THA procedure. Summary: We propose to develop a novel 18F-FDG PET/MRI approach with metal artifact correction methods for early detection of periprosthetic complications causing PPSP following THA. Successful implementation of our method will enable early indication of individualized, effective treatments for THA patients with PPSP.

项目摘要 概述：该项目旨在开发一种可靠的 18F-氟脱氧葡萄糖 (18F-FDG) PET/MRI 方法， 新型金属伪影矫正技术，可及早识别导致假体并发症的因素 全髋关节置换术（THA）后持续性术后疼痛（PPSP）。 相关性：THA 是治疗终末期髋关节疼痛和关节疼痛的发展最快的手术之一。 到 2030 年，每年的病例数估计将达到 572,000 例。不幸的是，相当多的病例 的患者在手术后经历 PPSP，如果没有适当的治疗，可能会严重损害患者的功能 生活质量。然而，早期识别这些患者的疼痛发生器非常困难，因为 目前的诊断方法包括 X 射线、CT 和 MRI，对疼痛的敏感性有限，并且患有严重的疼痛 由假体中的金属引起的伪影。因此，迫切需要一种新的诊断方法 准确识别导致持续性疼痛的异常炎症变化，以指导适当的治疗 治疗与疼痛的确切来源相匹配。 方法：我们建议使用 18F-FDG PET/MRI 来早期识别 THA 后的 PPSP 来源。 我们之前针对慢性疼痛综合征的 18F-FDG PET/MRI 研究表明，在 检测疼痛炎症部位。然而，金属假体附近的严重金属伪影限制了 18F-FDG PET/MRI 在 THA 患者中的应用因此，我们这个项目的首要目标是开发 对 PET 进行金属感知衰减校正，以在金属假体附近实现可靠的 18F-FDG PET。我们的 第二个目标是开发具有金属伪影校正功能的 3T 高分辨率髋关节 MRI，以改善我们的 识别 PPSP 症状结构性原因的能力。我们的第三个目标是验证 18F 的改进- 与 PET/CT 和传统 MRI 相比，FDG PET/MRI 检测疼痛源。这将是 通过将 6 个月时的疼痛评分测量值与 18F-FDG PET/MRI 异常相关联来完成， 单侧 THA 手术后 12 个月和 18 个月。 摘要：我们建议开发一种具有金属伪影校正方法的新型 18F-FDG PET/MRI 方法 用于早期发现 THA 后引起 PPSP 的假体周围并发症。成功实施 我们的方法将为患有 PPSP 的 THA 患者提供个体化、有效治疗的早期指示。