Localization of Back Pain by Assessment of Sigma-1 Receptor Expression using PET/MR imaging

Motivation: Diagnosis of chronic low back pain remains a challenge with conventional diagnostic methods leading to unsatisfactory treatment in a vast majority of patients. Goal(s): To investigate the use of sigma-1 receptor (S1R) radioligand, [18F] FTC-146 in conjunction with positron emission tomography/magnetic resonance imaging (PET/MRI) for identifying the pain generator in chronic low back pain. Approach: Correlation of [18F] FTC-146 PET-MRI imaging in patients with unresolved chronic low back pain to clinical findings. Results: S1R PET/MRI imaging matched the clinical diagnosis in all cases. Additionally, it offered benefit over traditional MRI by identifying additional “functional” findings both within and outside the spine. Impact: Future clinical implementation of S1R-PET/MR can potentially help reveal previously unidentified pain generator in patients with chronic low back pain that have exhausted standard clinical care leading to better-targeted treatment.