S1R Imaging-Based Cryoneurolysis in Chronic Pain

Molecular Imaging-Based Cryoneurolysis: Targeting Upregulated Sigma-1 Receptor Positive Nerves in Chronic Pain

The goal of this clinical trial is to determine whether a sigma-1 receptor PET/MRI scan can help identify the specific nerves responsible for chronic pain.

Researchers will use an investigational imaging agent called [18F]FTC-146 to look for signs of pain generating nerve irritation or injury that may not be visible on convention imaging tests.

Participants whose pain-generating nerve can be identified may undergo a diagnostic nerve block and, if successful, a standard clinical procedure called cryoneurolysis will be used to temporarily interrupt pain signals.

Inclusion Criteria:

1. Chronic nociceptive, neuropathic, or mixed pain for ≥2 months
2. Pain originating from a region amenable to cryoneurolysis (celiac plexus, intercostal nerves, pudendal nerve, peripheral nerve block
3. Chronic pain ≥2 months
4. Pain score ≥4/10
5. Pain location amenable to cryoneurolysis
6. Willing and able to provide consent.

Exclusion Criteria:

1. Pregnancy or nursing.
2. Non-English speaking individuals
3. Contraindication to MRI scanning which includes, but is not limited to, incompatible metal or hardware including pacemakers, cochlear implants, and bullets near a critical organ.
4. Weight >350 pounds or a large body habitus, which the MR scanner cannot accommodate.
5. Claustrophobia or feeling that he or she will be unable to lie still in the scanner for a period of 2 hours or fit in the PET/MR scanner due to body size.