Comparison of single photon emission computed tomography-computed tomography, computed tomography and magnetic resonance imaging of medication-related osteonecrosis of jaw by new calculated parameters.

BACKGROUND

This study aimed to investigate parameters for medication-related osteonecrosis of jaw (MRONJ) patients using the bone SPECT/CT, especially bone mineral-based parameters.

METHODS

Sixty-three patients with MRONJ (43 osteoporosis and 20 bone metastasises) underwent CT, MRI and SPECT/CT. A commercially available software automatically detected lesion area and calculated the quantitative SPECT/CT parameters as bone mineral-based standardized uptake value (SUV).

RESULTS

Regarding stage of MRONJ patients, bone mineral based maximum SUV of stage 3 was significantly higher than stage 1, 2 (P=0.018). Regarding duration of medication therapy, bone mineral based maximum SUV 1 year or more was significantly higher than less than 1 year (P=0.019). Regarding present of periosteal bone proliferation on CT, bone mineral based maximum SUV was significantly higher than those of absent (P=0.029). Regarding spread of soft tissue inflammation on MRI, bone mineral based maximum SUV of 2 or more was significantly higher than those of less than 2 spaces (P=0.025). Regarding blood pool phase imaging with SPECT, bone mineral based maximum SUV of intense uptake was significantly higher than those of decrease uptake (P=0.002).

CONCLUSIONS

SPECT/CT bone mineral-based parameters indicated significant difference in staging, dosing period, periosteal bone proliferation on CT, spread of soft tissue inflammation on MRI, and blood phase imaging with SPECT. Bone SPECT/CT bone mineral-based parameters are helpful for the assessment of MRONJ.