Molecular Imaging May Pinpoint Source of Chronic Back Pain

Stanford University researchers have presented a molecular imaging procedure that is capable of focusing on sites of abnormal bone reaction, which they say may help physicians provide more accurate diagnoses and appropriate pain management for patients with implants or bone grafts.

The findings were presented at the Society of Nuclear Medicine’s 58th Annual Meeting, in San Antonio, according to a Society of Nuclear Medicine press release. In the study, a combination of positron emission tomography and CT (PET/CT), and F18 NaF — an injected radiotracer that uses sodium fluoride to target areas of high bone turnover and inflammation — was used to evaluate patients with back pain after spinal surgery.

“With PET/CT, we can pinpoint the exact screw or rod that was loose or failing,” study author Andrew Quon, MD, stated in the release. “This eliminates unnecessary or erroneous hardware replacement surgeries and provides a surgical map for patients who need further operations to treat their chronic pain.”

Quon and his team used PET/CT and F18 NaF to prospectively evaluate 20 patients with spinal pain and used the procedure at least 8 months postoperatively in all cases. Twenty-four bone or tissue abnormalities were found in 17 of the 20 patients. Twelve of the 20 patients ultimately received exploratory surgery, with another four receiving local anesthetic nerve blockade.

In more than 85% of cases, the authors reported in the release, F18 NaF PET/CT was able to identify the source of the patient’s pain. Structure of the bone and physiological processes involved were highlighted, indicating areas where injury and infection may be located.

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