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Abstract #0159

The potential of FDG PET/MRI for identification of pain generators in patients with diagnostically challenging chronic musculoskeletal pain

Jacob M Mostert1, Edwin HG Oei1, Michael Ananta1, Galied SR Muradin1, Frank JPM Huygen2, Cecile C de Vos2, Pieter K Bos3, Sandip Biswal4, and Rianne A van der Heijden1,4
1Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands, 2Anesthesiology, Erasmus University Medical Center, Rotterdam, Netherlands, 3Orthopedics, Erasmus University Medical Center, Rotterdam, Netherlands, 4University of Wisconsin-Madison, Madison, WI, United States

Synopsis

Keywords: Other Musculoskeletal, PET/MR, Pain, low back pain, hip replacement

Motivation: Chronic low back pain (LBP) and persistent hip pain after total hip replacement (THR) are frequently under-treated, because conventional imaging methods like CT or MRI often fail to accurately locate the source of pain in these patients.

Goal(s): To assess the clinical benefits of [18F]FDG PET/MRI for pinpointing pain generators in patients with diagnostically challenging LBP or post-THR hip pain.

Approach: Randomized controlled trial comparing [18F]FDG PET/MRI against standard clinical care.

Results: [18F]FDG PET/MRI successfully identified previously undetected pain sources in patients with chronic LBP or persistent hip pain after THR, prompting more frequent changes in clinical management than standard care.

Impact: In patients with diagnostically challenging chronic low back pain or persistent pain after total hip replacement, [18F]FDG PET/MRI uncovered previously undetected pain sources. PET/MRI shows promise as a useful diagnostic tool in patients suffering from diagnostically challenging chronic pain.

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