Chandigarh: PGIMER introduces world’s first PET-CT guided precision therapy for chronic pain

The Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, has achieved a global milestone with the introduction of a first-in-the-world technique for precise management of chronic musculoskeletal pain using Fluorine-18 Sodium Fluoride (¹⁸F-NaF) PET-CT guided steroid injections.

Lauding the path-breaking innovation, Prof Vivek Lal, Director, PGIMER, stated, “This pioneering advancement reflects PGIMER’s continued commitment to patient-centric innovation and clinical excellence. By integrating cutting-edge functional imaging with targeted therapy, this technique has the potential to transform chronic pain management globally while remaining accessible and affordable for patients.”

Elaborating on the breakthrough, Dr Anish Bhattacharya, Professor and Head, Department of Nuclear Medicine, PGIMER, stated, “Unlike conventional imaging, NaF PET-CT identifies metabolically active disease sites, enabling us to precisely locate the true pain generator. This ensures that treatment is directed exactly where it is needed, significantly improving outcomes.”

The multidisciplinary team behind this innovation includes Dr Anish Bhattacharya, (Professor & Head, Nuclear Medicine), Dr Sarvdeep Singh Dhatt (Professor, Orthopaedics), Dr Babita Ghai (Professor, Anaesthesia and Intensive Care), Dr Rajender Kumar (Additional Professor, Nuclear Medicine), Dr Vishal Kumar (Additional Professor Orthopaedics), Dr Harmandeep Singh (Additional Professor, Nuclear Medicine), and Dr Raza Abbas Mahdi (Senior Resident, Nuclear Medicine) working collaboratively to advance precision pain therapy.

Dr Dhatt, Department of Orthopaedics, stated while sharing the scope of the treatment, “This novel approach addresses a long-standing challenge in pain management—accurately identifying the exact source of pain. Chronic conditions such as lumbar facet joint arthropathy, sacroiliitis, plantar fasciitis, Achilles tendinitis, and coccydynia often remain inadequately treated due to limitations of conventional imaging modalities.

Dr Vishal Kumar, Department of Orthopaedics, PGIMER, speaking about the genesis of the technique, said, “It all began with a debate that, despite having the best expertise, we were not doing enough for our patients. That introspection led to the development of this novel approach.”

Dr Rajender Kumar, Additional Professor, Department of Nuclear Medicine, detailed, “The technique involves identifying the active pain-generating site using NaF PET-CT, followed by highly targeted steroid injection under real-time PET-CT guidance, further enhanced by robotic assistance for unmatched precision.

Clinical outcomes from PGIMER demonstrate that nearly 84% of patients experienced significant pain relief at three months, a marked improvement over conventional approaches. Importantly, the procedure is safe, with no major complications reported, added Dr Rajendra Kumar.

In a notable step towards affordability, the procedure costs approximately ₹1,000, with consumables around ₹500, making it accessible to a large number of patients. Appointments are currently available within 1–2 weeks of referral.

This innovation marks a paradigm shift towards precision-guided, personalized pain therapy, offering renewed hope to patients suffering from chronic musculoskeletal pain who have not responded to conventional treatments.

The innovation is backed by robust clinical evidence published in the European Journal of Nuclear Medicine and Molecular Imaging (2026; 53:1279–1288) titled “Efficacy and safety of [18F]NaF PET/CT guided intraarticular block for lumbar facet joint and sacroiliac joint arthropathy: a single-arm phase 2 trial.”

The study reported that the primary endpoint of ≥50% pain reduction was achieved in 84% of patients, with significant improvements in disability and functional scores, and no major adverse effects—underscoring the safety and effectiveness of this novel technique.