BACKGROUND AND PURPOSE:Imaging of bisphosphonate-induced osteonecrosis of the jaw is essential for surgical planning. We compared the extent of BONJ on contrast-enhanced MR imaging, [(18)F] fluoride PET/CT, and panoramic views derived from standard conebeam CT with clinical pre- and intraoperative examinations. MATERIALS AND METHODS:Between February 2011 and January 2012, ten subjects with written informed consent (9 women; mean, 69.6 years; range, 53-88 years) were included in this prospective ethics-board-approved study. Patients underwent CEMR imaging, [(18)F] fluoride PET/CT, and CBCT and were clinically examined pre- and intraoperatively. Surgery was performed, and BONJ was histologically confirmed in 9 patients. Location and extent of BONJ on different modalities/examinations were graphically compared (0 = no pathologic finding, 1 = smallest, 5 = largest extent of BONJ). Rank tests were used to assess overall and paired differences of ratings in 9 patients. A P value <.05 was considered statistically significant. RESULTS:Significant differences in BONJ extent among different modalities and examinations were found (P < .001). The highest median rank was seen in PET/CT (4 ± 1.12) and CEMR imaging (4 ± 1.01), followed by intraoperative examinations (3 ± 0.71), CBCT (2 ± 0.33), and preoperative examinations (1 ± 0). No significant differences were found between PET/CT and CEMR imaging (P = .23), except when comparing PET/CT to either CBCT, pre- and intraoperative examinations (all P < .05). Preoperative examinations showed significantly less extensive disease than all other modalities/examinations (all P < .05). CONCLUSIONS:[(18)F] fluoride PET/CT and CEMR imaging revealed more extensive involvement of BONJ compared with panoramic views from CBCT and clinical examinations.

译文

背景与目的:双膦酸盐诱发的颌骨骨坏死的成像对于手术计划至关重要。我们将BONJ在对比增强MR成像,[(18)F]氟化物PET / CT和标准锥束CT的全景图与临床术前和术中检查之间进行了比较。
材料与方法:在2011年2月至2012年1月之间,该前瞻性伦理委员会批准的研究包括十名获得书面知情同意的受试者(9名女性;平均69.6岁;范围53-88岁)。患者接受了CEMR成像,[(18)F]氟化物PET / CT和CBCT,并在术前和术中接受了临床检查。进行了手术,并在组织学上证实了9例患者的BONJ。以图形方式比较了BONJ在不同模态/检查中的位置和程度(0 =无病理发现,1 =最小,5 =最大程度的BONJ)。等级检验用于评估9位患者的总体和配对等级差异。 P值<.05被认为具有统计学意义。
结果:在不同的方式和检查之间,BONJ范围存在显着差异(P <.001)。 PET / CT(4±1.12)和CEMR成像(4±1.01),手术中检查(3±0.71),CBCT(2±0.33)和术前检查(1±0)最高。除了将PET / CT与CBCT,术前和术中检查进行比较(所有P <.05)之外,PET / CT和CEMR成像之间没有发现显着差异(P = 0.23)。术前检查显示,与所有其他方式/检查相比,病灶明显更少(所有P <.05)。
结论:[(18)F]氟化物PET / CT和CEMR成像显示,与CBCT和临床检查的全景图相比,BONJ的介入程度更大。

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