# Novel PET/MR Imaging Approach for Persistent Postsurgical Pain Following Joint Replacement

> **NIH NIH R56** · STANFORD UNIVERSITY · 2020 · $577,581

## Abstract

Project Abstract
Overview: This project aims to develop a novel 18F-fluorodeoxyglucose (18F-FDG) PET/MRI method with novel
metal artifact correction techniques to provide early identification of painful complications in the prosthetic joint
area 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 is estimated to reach 572,000 annual cases 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 pain without prohibitive metal artifacts to guide
the appropriate treatment matched to the exact cause 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 maximize our
ability to identify morphologic causes of PPSP symptoms. Our third aim is to validate the improvements in
detection of the painful lesions using serial 18F-FDG PET/MRI sessions. 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 method with metal artifact correction
techniques for early detection of complications causing PPSP following THA. Successful implementation of our
method will enable early indication of individualized, effective treatments for THA patients with PPSP.

## Key facts

- **NIH application ID:** 10226582
- **Project number:** 1R56AR077706-01
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** SANDIP BISWAL
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $577,581
- **Award type:** 1
- **Project period:** 2020-09-03 → 2021-05-04

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10226582

## Citation

> US National Institutes of Health, RePORTER application 10226582, Novel PET/MR Imaging Approach for Persistent Postsurgical Pain Following Joint Replacement (1R56AR077706-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10226582. Licensed CC0.

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