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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

基本信息

批准号：
10766883
负责人：
SANDIP BISWAL
金额：
$ 57.93万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-05 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10766883
关键词：
Acceleration 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 History Metabolic Metals Methods Modeling 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 chronic pain diagnostic strategy diagnostic tool effective therapy experience 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 source localization success uptake validation studies

项目摘要

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：本项目旨在开发一种可靠的18F-FDG PET/MRI方法，新的金属伪影矫正技术，以提供早期识别假体并发症，全髋关节置换术（THA）后持续性术后疼痛（PPSP）。相关性：全髋关节置换术是治疗终末期髋关节疼痛发展最快的手术之一，据估计，到2030年，其年度病例将达到572，000例。不幸的是，的患者在手术后经历PPSP，如果没有适当的治疗，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，假体中金属引起的伪影。因此，迫切需要一种新的诊断方法，准确识别引起持续性疼痛的异常炎症变化，以指导适当的与疼痛的确切来源相匹配的治疗。方法：我们建议使用18F-FDG PET/MRI早期识别THA后PPSP的来源。我们之前对慢性疼痛综合征的18F-FDG PET/MRI研究表明，检测疼痛的炎症部位。然而，金属假体附近严重的金属伪影限制了 18F-FDG PET/MRI在THA患者中的应用。因此，我们在这个项目中的第一个目标是开发 PET的金属感知衰减校正，使金属假体附近的18F-FDG PET可靠。我们第二个目标是开发3 T的高分辨率髋关节MRI，并进行金属伪影校正，以改善我们的识别PPSP症状的结构性原因的能力。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在检测疼痛发生器方面的作用。这将是通过将疼痛评分测量与6个月时的18F-FDG PET/MRI异常相关联来完成，单侧THA术后12个月和18个月。总结：我们建议开发一种新的具有金属伪影校正方法的18F-FDG PET/MRI方法早期发现THA术后引起PPSP的假体周围并发症。成功实施我们的方法将使PPSP的THA患者的个体化、有效治疗的早期指征成为可能。