¹⁸F-FDG PET/MRI in Chronic Sciatica: Early Results Revealing Spinal and Nonspinal Abnormalities

Chronic sciatica is a major cause of disability worldwide, but accurate diagnosis of the causative pathology remains challenging. In this report, the feasibility of an ¹⁸F-FDG PET/MRI approach for improved diagnosis of chronic sciatica is presented. Methods:¹⁸F-FDG PET/MRI was performed on 9 chronic sciatica patients and 5 healthy volunteers (healthy controls). Region-of-interest analysis using SUV_max was performed, and ¹⁸F-FDG uptake in lesions was compared with that in the corresponding areas in healthy controls. Results: Significantly increased ¹⁸F-FDG uptake was observed in detected lesions in all patients and was correlated with pain symptoms. ¹⁸F-FDG-avid lesions not only were found in impinged spinal nerves but also were associated with nonspinal causes of pain, such as facet joint degeneration, pars defect, or presumed scar neuroma. Conclusion: The feasibility of ¹⁸F-FDG PET/MRI for diagnosing pain generators in chronic sciatica was demonstrated, revealing various possible etiologies.