FDG PET/MR Imaging of Peripheral Pain Generators

NCT ID: NCT06171659

Last Updated: 2025-09-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

128 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-11-19

Study Completion Date

2027-06-30

Brief Summary

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The purpose of this research is to determine if a PET/MRI scan using FDG can accurately identify the source of chronic pain. Identifying the source of pain may help doctors treat chronic pain more effectively. Approximately 128 participants will be enrolled and can expect to be on study for up to 12 months.

Detailed Description

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The investigators aim to precisely localize sites of increased inflammation and potentially pain generation and improve understanding of nociception and inflammation using a unique, hybrid PET/MRI approach in conjunction with intravenously, administered fluorodeoxyglucose (FDG), which has been shown with PET imaging to be an sensitive surrogate marker of inflammation.

The Primary Objective of this pilot prospective, observational research is to determine whether this approach, which combines PET/MRI and an FDA-approved radiotracer, 18F-Fluorodeoxyglucose (FDG), can accurately localize the sites of painful inflammation in individuals with persistent pain.

* Determine if increased FDG uptake on PET as measured by standard uptake value (SUV) or target-to-background (TTB) measurements is increased in area of pain symptoms when compared to same corresponding areas in healthy, asymptomatic volunteers.
* Determine whether amount of FDG uptake as measured on PET is able to localize to abnormalities when compared to MR imaging (T2 signal intensity, morphologic aberrations)

Secondary Objectives:

* Verify that the standard administered adult dose of FDG (0.14 mCi/kg/patient) used currently in the clinics can also be used to detect peripheral pain generators.
* Verify that FDG uptake in asymptomatic, healthy controls will be significantly less than their chronic pain cohorts at the same anatomic location.
* Determine whether longitudinal FDG PET/MR imaging findings in individual patients directly correlate with symptoms as they evolve over time in joint arthroplasty subjects with PPSP.
* Determine if FDG PET/MR imaging findings spatially differ between different pain types.

Conditions

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Pain Nociceptive Pain

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Open Surgical Procedure (Arthroplasty)

PPSP subjects who have undergone hip (or knee) joint arthroplasty (i.e., open surgical procedure for joint replacement).

* 6 month post-op scans
* 12 month post-op scans
* 18 month post-op scans

FDG radiotracer

Intervention Type DRUG

Fludeoxyglucose F 18 Injection is a positron emitting radiopharmaceutical containing no-carrier added radioactive 2-deoxy-2-\[18F\]fluoro-D-g1ucose, which is used for diagnostic purposes in conjunction with Positron Emission Tomography (PET). It is administered by intravenous injection. Dosage planned 0.14 mCi/kg/patient.

PET/MRI

Intervention Type DEVICE

positron emission tomography and magnetic resonance imaging

PET/CT imaging

Intervention Type DEVICE

positron emission tomography and computed tomography imaging

Less Invasive Procedure (Arthroscopy)

PPSP subjects who have undergone hip (or knee) arthroscopy (i.e., less invasive joint surgical procedure involving scopes and lower profile surgical tools)

\- 6 month post-op scans

FDG radiotracer

Intervention Type DRUG

Fludeoxyglucose F 18 Injection is a positron emitting radiopharmaceutical containing no-carrier added radioactive 2-deoxy-2-\[18F\]fluoro-D-g1ucose, which is used for diagnostic purposes in conjunction with Positron Emission Tomography (PET). It is administered by intravenous injection. Dosage planned 0.14 mCi/kg/patient.

PET/MRI

Intervention Type DEVICE

positron emission tomography and magnetic resonance imaging

PET/CT imaging

Intervention Type DEVICE

positron emission tomography and computed tomography imaging

Asymptomatic: Had Total Joint Replacement (Arthroplasty)

Asymptomatic subjects who have undergone total hip or total knee arthroplasty.

\- single scan during one study visit (up to 3.5 hours)

FDG radiotracer

Intervention Type DRUG

Fludeoxyglucose F 18 Injection is a positron emitting radiopharmaceutical containing no-carrier added radioactive 2-deoxy-2-\[18F\]fluoro-D-g1ucose, which is used for diagnostic purposes in conjunction with Positron Emission Tomography (PET). It is administered by intravenous injection. Dosage planned 0.14 mCi/kg/patient.

PET/MRI

Intervention Type DEVICE

positron emission tomography and magnetic resonance imaging

PET/CT imaging

Intervention Type DEVICE

positron emission tomography and computed tomography imaging

Asymptomatic: Less Invasive Procedure (Arthroscopy)

Asymptomatic subjects who have undergone hip or knee arthroscopy.

\- single scan during one study visit (up to 3.5 hours)

FDG radiotracer

Intervention Type DRUG

Fludeoxyglucose F 18 Injection is a positron emitting radiopharmaceutical containing no-carrier added radioactive 2-deoxy-2-\[18F\]fluoro-D-g1ucose, which is used for diagnostic purposes in conjunction with Positron Emission Tomography (PET). It is administered by intravenous injection. Dosage planned 0.14 mCi/kg/patient.

PET/MRI

Intervention Type DEVICE

positron emission tomography and magnetic resonance imaging

PET/CT imaging

Intervention Type DEVICE

positron emission tomography and computed tomography imaging

Interventions

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FDG radiotracer

Fludeoxyglucose F 18 Injection is a positron emitting radiopharmaceutical containing no-carrier added radioactive 2-deoxy-2-\[18F\]fluoro-D-g1ucose, which is used for diagnostic purposes in conjunction with Positron Emission Tomography (PET). It is administered by intravenous injection. Dosage planned 0.14 mCi/kg/patient.

Intervention Type DRUG

PET/MRI

positron emission tomography and magnetic resonance imaging

Intervention Type DEVICE

PET/CT imaging

positron emission tomography and computed tomography imaging

Intervention Type DEVICE

Other Intervention Names

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fluorodeoxyglucose 18F-Fluorodeoxyglucose

Eligibility Criteria

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Inclusion Criteria

* 18-85 years old
* Presents with persistent pain with pain score of ≥4 on Numerical Rating Scale \[0:10\] for at least 6 months following joint arthroplasty or arthroscopy.
* Able and willing to provide informed consent
* Willing and able to undergo PET/MRI (arthroplasty and arthroscopy participants) and PET/CT (arthroplasty participants only)


* 18-85 years old
* Asymptomatic (pain score of ≤2 on the NRS) for at least 6 months following joint arthroplasty or arthroscopy.
* Able and willing to provide informed consent
* Willing and able to undergo PET/MRI

Exclusion Criteria

* Inability to understand and communicate with the investigators to complete the study-related questionnaires.
* Any co-morbidity which results in severe systemic disease limiting function as defined by the American Society of Anesthesiology (ASA) physical status classification \> 3, such as the presence of current or past (6 months) pulmonary, hepatic, renal disease, arthritis, hematopoietic, and neurological diseases not related to chronic pain.
* Pregnant or breastfeeding. (Individuals with childbearing potential will be asked to verbally confirm they are not pregnant. If they cannot confirm, they will have a urine pregnancy test either at the imaging study visit or within 7 days prior to the imaging study visit.)
* Subject with contraindication(s) to or inability to undergo PET/MRI
* Current diagnosis of malignancy of any kind. Participants in remission for at least two years and not undergoing any treatment may be considered per investigator discretion
* Current enrollment in a scientific interventional or treatment study.
* Subject unable or unwilling to provide informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

NIH

Sponsor Role collaborator

Arthroscopy Association of North America (AANA)

UNKNOWN

Sponsor Role collaborator

University of Wisconsin, Madison

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sandip Biswal, MD

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Locations

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UW School of Medicine and Public Health

Madison, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Radiology Studies

Role: CONTACT

608-282-8349

Other Identifiers

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R01AR077706

Identifier Type: NIH

Identifier Source: secondary_id

View Link

SMPH/RADIOLOGY/RADIOLOGY

Identifier Type: OTHER

Identifier Source: secondary_id

Protocol Version 11/1/2024

Identifier Type: OTHER

Identifier Source: secondary_id

2023-0884

Identifier Type: -

Identifier Source: org_study_id

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