Abstract #2969

Foraminal [18F]FDG uptake on PET/MRI is associated with radicular symptoms and pain reduction after image-guided nerve root block

Virginie Kreutzinger¹, Katharina Ziegeler¹, Misung Han¹, Cynthia T. Chin¹, Chase H. Fitch², Emma Bahroos¹, Thomas M. Link¹, Sharmila Majumdar¹, and Daehyun Yoon¹

¹Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, United States, ²University of San Francisco, San Francisco, CA, United States

Synopsis

Keywords: Bone/Skeletal, PET/MR, spine, low back pain, image-guided nerve root block

Motivation: The correlation of morphological findings on MRI and radiating low back pain (rLBP) is limited. Nerve irritation, visualized as increased glucose metabolism in FDG-PET-MRI, is a promising tool to identify symptomatic segments.

Goal(s): To investigate the association of foraminal [18F]FDG uptake on PET/MRI and radiological pathology as well as patient outcomes.

Approach: Patients with rLBP received both MRI and [18F]FDG PET of the lumbar spine; a subset of patients received image-guided nerve root block as part of their standard clinical care.

Results: Nerve irritation, as visualized by [18F]FDG PET/MRI, is associated with foraminal stenosis and pain outcomes.

Impact: Foraminal [18F]FDG uptake on PET/MRI as a surrogate marker of nerve irritation may improve the identification of pain generators on lumbar spine imaging in patients with radiating low back pain.

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