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: 10211307
• 负责人: SANDIP BISWAL
• 金额: $ 42.02万
• 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 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10211307
• 关键词: Address; Analgesics; Area; Arthralgia; Awareness; Classification; Clinical; Custom; Detection; Development; Diagnosis; Diagnostic; Diagnostic Imaging; Diagnostic Procedure; Diagnostic radiologic examination; 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; Structure; Surveys; Syndrome; Techniques; Time; Tracer; Training; Validation; Water; attenuation; base; chronic pain; 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; tool; 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：该项目旨在开发一个可靠的18F-氟脱氧葡萄糖（18F-FDG）PET/MRI方法 新型的金属伪影校正技术可早期鉴定引起的假肢并发症 总髋关节置换术（THA）后，持续性术后疼痛（PPSP）。 相关性：THA是治疗末期髋关节疼痛和 功能障碍及其年度病例估计到2030年将达到572,000。 在手术后经历PPSP的患者，如果没有适当的治疗，可能会大大损害 生活质量。但是，这些患者对疼痛发生器的早期鉴定非常困难，因为 当前的诊断方法在内，包括X射线，CT和MRI，对疼痛的敏感性有限，并且患有严重 金属在假体中引起的伪影。因此，迫切需要采用新颖的诊断方法 准确地确定异常的炎症变化，导致持续性疼痛以指导适当 治疗与确切的疼痛来源相匹配。 方法：我们建议使用18F-FDG PET/MRI早期鉴定THA后PPSP的来源。 我们以前的18F-FDG PET/MRI慢性疼痛综合症研究表明有希望的改善 检测疼痛炎症的部位。但是，金属假体附近的严重金属伪像限制了 将18F-FDG PET/MRI应用于患者。因此，我们在该项目中的第一个目标是开发 PET的金属感知衰减校正可以在金属假体附近实现可靠的18F-FDG PET。我们的 第二个目的是通过金属伪影校正在3T处开发高分辨率的髋关节MRI，以改善我们的 识别PPSP症状的结构原因的能力。我们的第三个目标是通过18F-验证改进 与PET/CT和常规MRI相比，FDG PET/MRI检测疼痛发生器。这将是 通过将疼痛评分测量与6个月时的18F-FDG PET/MRI异常相关联，完成 单方面手术后的12个月和18个月。 摘要：我们建议使用金属伪影方法开发一种新型的18F-FDG PET/MRI方法 为了早日检测，在THA之后引起PPSP的周围并发症。成功实施 我们的方法将使PPSP患者的个性化有效治疗能够尽早指示。