In recent years, image-guided procedures are playing an emerging and active role in pain management and in improving the quality of life of patients with benign diseases or malignancies. In particular, reduction of pain without systemic side effects can be achieved with precise percutaneous or intra-arterial imaging-guided techniques, as well as stereotactic radiotherapy. New locoregional options, in terms of techniques as well as new devices or technological improvements, have emerged. These offer safe and effective methods of pain relief in patients refractory to traditional analgesic therapies, or of pain control, allowing to control the amount of pain medication administered.

For cancer pain management, we have two different ways of action: indirect, based on regional anaesthesia from neurolytic block (neurolysis – injecting alcohol or phenol), and direct action on the tumour with percutaneous locoregional ablative treatment (alcohol, laser, radiofrequency, microwaves, high-intensity focused ultrasound (HIFU), cryoablation, and radiotherapy). On the other hand, for pain unrelated to cancer, image-guided interventionalists can perform a wide variety of procedures targeting different structures, such as desiccated degenerative discs (intradiscal therapy), collapsed or weakened vertebra, painful joints (intra-articular with percutaneous approaches, but also intra-arterial embolotherapy), bursae, peripheral nerves, and autonomic plexi. Several indications have previously been validated, but additional applications should be tested over the next few years, with many potential innovations on the horizon, including intradiscal biological therapy (stem cells, platelet-rich plasma), ozone therapy, chemonucleolysis, decompression, drug delivery, and more.

This Special Issue welcomes articles on innovations in diagnostic and image-guided interventions with a multidisciplinary approach, leading to the development of predictive and personalized therapies for safe and effective pain management. We also encourage the submission of review articles that describe the current state of the art. New perspectives will also be focused on animal research with the possibility to have translational studies to humans and clinics.

Potential topics include but are not limited to the following:

• Imaging for pre-procedural planning and selection of image-guided therapy
• Correlation between imaging findings and location/severity of the patient’s pain
• Fusion Imaging/Navigation Systems and procedural efficacy
• Novel types of contrast medium and new sequences/acquisitions in Intra-articular MRI/CT imaging
• Software-guided percutaneous treatments of pain related or unrelated to cancer
• Cone-beam Computed Tomography (CB-CT) for intraprocedural three-dimensional volumetric imaging
• Imaging predictors of response or recurrence after locoregional pain management
• Novel types of contrast medium and new sequences/acquisitions in Intra-articular MRI/CT imaging
• Imaging and stereotactic radiotherapy/brachitherapy
• Non-neoplastic spine pain
• Peripheral nerve ablation or neuromodulation
• Vertebral augmentation
• Cryoneurolysis
• Catheter-directed therapy for non-spinal neoplastic or non-neoplastic pain
• Percutaneous ablative treatments (alcohol, laser, radiofrequency, microwaves, HIFU, cryoablation, reversible or irreversible electroporation)
• Basic and animal research in order to develop model-specific pain management protocols