PDF(Pubmed)
Abstract：
Introduction: Chronic pelvic pain is a highly prevalent pain condition among women, but identifying the exact cause of pelvic pain remains a significant diagnostic challenge. In this study, we explored a new diagnostic approach with PET/MRI of the sigma-1 receptor, a chaperone protein modulating ion channels for activating nociceptive processes. Methods: Our approach is implemented by a simultaneous PET/MRI scan with a novel radioligand [18F]FTC-146, which is highly specific to the sigma-1 receptor. We recruited 5 chronic pelvic pain patients and 5 healthy volunteers and compared our PET/MRI findings between these two groups. Results: All five patients showed abnormally increased radioligand uptake on PET compared to healthy controls at various organs, including the uterus, vagina, pelvic bowel, gluteus maximus muscle, and liver. However, on MRI, only 2 patients showed abnormalities that could be potentially associated with the pain symptoms. For a subset of patients, the association of pain and the abnormally increased radioligand uptake was further validated by successful pain relief outcomes following surgery or trigger point injections to the identified abnormalities. Conclusion: In this preliminary study, sigma-1 receptor PET/MRI demonstrated potential for identifying abnormalities associated with chronic pelvic pain. Future studies will need to correlate samples with imaging findings to further validate the correlation between S1R distribution and pathologies of chronic pelvic pain. Trial Registration: The clinical trial registration date is June 2, 2018, and the registration number of the study is NCT03195270 (https://clinicaltrials.gov/ct2/show/NCT03556137).
摘要：
简介：慢性盆腔疼痛是女性中非常普遍的疼痛状况，但是确定盆腔疼痛的确切原因仍然是一个重大的诊断挑战。在这项研究中,我们用sigma-1受体的PET/MRI探索了一种新的诊断方法，一种伴侣蛋白调节离子通道，用于激活伤害性过程。方法：我们的方法是通过使用新型放射性配体[18F]FTC-146同时进行PET/MRI扫描来实现的，该配体对sigma-1受体具有高度特异性。我们招募了5名慢性盆腔疼痛患者和5名健康志愿者，并比较了这两组之间的PET/MRI检查结果。结果：与健康对照相比，所有5例患者在PET上的放射性配体摄取异常增加，包括子宫,阴道,盆腔肠,臀大肌,还有肝脏.然而,核磁共振成像,只有2例患者表现出可能与疼痛症状相关的异常.对于一部分患者，疼痛和放射性配体摄取异常增加的相关性通过手术或触发点注射确定的异常后成功缓解疼痛的结局得到进一步验证.结论:在本初步研究中,sigma-1受体PET/MRI显示了识别与慢性盆腔疼痛相关的异常的潜力。未来的研究将需要将样本与影像学发现相关联，以进一步验证S1R分布与慢性盆腔疼痛病理之间的相关性。试验注册：临床试验注册日期为2018年6月2日，研究注册编号为NCT03195270（https://clinicaltrials.gov/ct2/show/NCT03556137）。
