At the SNMMI (Society of Nuclear Medicine & Molecular Imaging) 2020 Virtual Annual Meeting, two incredible medical imaging innovations were presented for the very first time. One demonstrated a PET/MRI approach to locate the exact locations of chronic pain in a patient, and the other was a new full-body scanner that can visualize the entire systemic burden of inflammatory arthritis.
Sandip Biswal, one of the project’s researchers, explained:
In the past few decades, we have confirmed that anatomic-based imaging approaches, such as conventional MRI, are unhelpful in identifying chronic pain generators. We know that 18F-FDG PET has the ability to accurately evaluate increased glucose metabolism that arises from acute or chronic pain generators. As such, in our study, we examined PET/MRI as a potential solution to determine the exact molecular underpinnings of one’s pain.
The PET/MRI Approach
The study, led by Stanford University School of Medicine researchers, recruited 65 subjects with chronic pain and conducted a full-body PET/MRI scan. 18F-FDG tracers were utilized to find particular locations in the tissue that had high levels of glucose. The technology effectively pinpointed the specific area of pain in 58 participants.
One of the participants had decades of chronic neck pain that was unresolved after several treatments until this clinical trial. The scan found the specific location with high FDG uptake, allowing the surgeon to investigate the spot. The doctor found that the source of the chronic pain was from numerous tiny arteries constricting a nerve. The patient then underwent a surgical procedure, called lysis, and reported significant relief to the chronic pain.
Biswal added:
The results of this study show that better outcomes are possible for those suffering from chronic pain. This clinical molecular imaging approach is addressing a tremendous unmet clinical need, and I am hopeful that this work will lay the groundwork for the birth of a new subspecialty in nuclear medicine and radiology.
The Full-Body Scanner
For the other study, researchers used a newly developed full-body imaging technology called uEXPLORER, to investigate the systemic effect of arthritis across all organs and joints simultaneously. uEXPLORER combines computed tomography (CT) and positron emission tomography (PET) to offer high-resolution full-body images with less radioactive tracers.
Even though arthritis is known as a systemic inflammatory condition, conventional imaging modalities only focus on some areas of the body at a time. This study demonstrates how the condition affects the entire body. The researchers recruited fourteen participants with either osteoarthritis, rheumatoid arthritis, or psoriatic arthritis, for imaging.
Yasser Abdelhafez, one of the study’s researchers, explained:
Total-body molecular imaging could provide currently unavailable, systemic, objective biomarkers that could help address the significant clinical challenges in managing inflammatory arthritic populations. The evaluation of arthritic disease activity at all joints of the body could have direct implications for disease staging, risk stratification, treatment selection, and monitoring of treatment response.
The study revealed how different kinds of arthritis have unique systemic inflammatory effects, and it demonstrates the potential of full-body imaging for arthritis.
