Journal of stomatology, oral and maxillofacial surgery · 2026
Diagnostic Value of Tc-99m-HDP SPECT/CT in Temporomandibular Joint Osteoarthritis: Correlation with Clinical and Structural Findings.
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Jeon Jun-Hyung, Baik Sung-Hyun, Yun Pil-Young, Ku Jeong-Kui
Аннотация
BACKGROUND: This study evaluated the diagnostic utility of quantitative Tc-99m-hydroxydiphosphonate (HDP) bone single-photon emission computed tomography/computed tomography (SPECT/CT) in temporomandibular joint osteoarthritis (TMJ OA) by analyzing correlations among tracer uptake, clinical features, and structural imaging to detect early metabolically active disease.
METHODS: A retrospective review included 48 patients (96 TMJs) with TMJ discomfort who underwent SPECT/CT and conventional imaging. Clinical parameters included pain duration, visual analog scale (VAS) score, joint sounds, mandibular range of motion, and occlusal findings. Radiography assessed condylar morphology and cortical erosion, and a Destructive Change Index (DCI) quantified bony changes. SPECT/CT uptake was expressed as maximum standardized uptake value (SUVmax). Correlation and receiver operating characteristic (ROC) analyses were performed.
RESULTS: SPECT/CT uptake strongly correlated with condylar cortical erosion on CT (r = 0.80) and moderately with lateral pole tenderness (r = 0.51) and pain VAS score (r = 0.40). Joint sounds and condylar morphology correlated weakly (r = 0.26 and 0.21, respectively), while other clinical factors had negligible associations. ROC analysis identified an optimal SUVmax cutoff of 3.88, yielding 91% sensitivity (95% CI: 80-97%) and 85% specificity (95% CI: 73-94%) for detecting cortical erosion. SPECT/CT revealed increased metabolic uptake in some radiographically normal joints, suggesting the possibility of early osteoarthritic change before overt structural abnormalities became apparent.
CONCLUSION: Quantitative SPECT/CT provides complementary metabolic information beyond structural imaging and may facilitate the detection of metabolically active TMJ osteoarthritis.
METHODS: A retrospective review included 48 patients (96 TMJs) with TMJ discomfort who underwent SPECT/CT and conventional imaging. Clinical parameters included pain duration, visual analog scale (VAS) score, joint sounds, mandibular range of motion, and occlusal findings. Radiography assessed condylar morphology and cortical erosion, and a Destructive Change Index (DCI) quantified bony changes. SPECT/CT uptake was expressed as maximum standardized uptake value (SUVmax). Correlation and receiver operating characteristic (ROC) analyses were performed.
RESULTS: SPECT/CT uptake strongly correlated with condylar cortical erosion on CT (r = 0.80) and moderately with lateral pole tenderness (r = 0.51) and pain VAS score (r = 0.40). Joint sounds and condylar morphology correlated weakly (r = 0.26 and 0.21, respectively), while other clinical factors had negligible associations. ROC analysis identified an optimal SUVmax cutoff of 3.88, yielding 91% sensitivity (95% CI: 80-97%) and 85% specificity (95% CI: 73-94%) for detecting cortical erosion. SPECT/CT revealed increased metabolic uptake in some radiographically normal joints, suggesting the possibility of early osteoarthritic change before overt structural abnormalities became apparent.
CONCLUSION: Quantitative SPECT/CT provides complementary metabolic information beyond structural imaging and may facilitate the detection of metabolically active TMJ osteoarthritis.