Browse > Article
http://dx.doi.org/10.5624/isd.2019.49.1.53

Tc-99m hydroxymethylene diphosphonate scintigraphy, computed tomography, and magnetic resonance imaging of osteonecrosis in the mandible: Osteoradionecrosis versus medication-related osteonecrosis of the jaw  

Ogura, Ichiro (Department of Oral and Maxillofacial Radiology, The Nippon Dental University, School of Life Dentistry at Niigata)
Sasaki, Yoshihiko (Radiology, The Nippon Dental University, Niigata Hospital)
Sue, Mikiko (Radiology, The Nippon Dental University, Niigata Hospital)
Oda, Takaaki (Radiology, The Nippon Dental University, Niigata Hospital)
Kameta, Ayako (Department of Oral and Maxillofacial Radiology, The Nippon Dental University, School of Life Dentistry at Niigata)
Hayama, Kazuhide (Department of Oral and Maxillofacial Radiology, The Nippon Dental University, School of Life Dentistry at Niigata)
Publication Information
Imaging Science in Dentistry / v.49, no.1, 2019 , pp. 53-58 More about this Journal
Abstract
Purpose: To present characteristic findings of Tc-99m hydroxymethylene diphosphonate (HMDP) scintigraphy, computed tomography (CT), and magnetic resonance (MR) imaging for osteonecrosis in the mandible, especially osteoradionecrosis(ORN) and medication-related osteonecrosis of the jaw(MRONJ). Materials and Methods: Thirteen patients with MRONJ and 7 patients with ORN in the mandible underwent Tc-99m HMDP scintigraphy, CT, and MR imaging (T1-weighted images[T1WI], T2-weighted images[T2WI], short inversion time inversion recovery images[STIR]), diffusion-weighted images[DWI], and apparent diffusion coefficient [ADC] mapping). The associations of scintigraphy, CT, and MR imaging findings with MRONJ and ORN were analyzed using the chi-square test with the Pearson exact test. Results: Thirteen patients with MRONJ and 7 patients with ORN in the mandible showed low signal intensity on T1WI and ADC mapping, high signal intensity on STIR and DWI, and increased uptake on scintigraphy. Periosteal bone proliferation on CT was observed in 69.2% of patients with MRONJ(9 of 13) versus 14.3% of patients with ORN(1 of 7)(P=0.019). Conclusion: This study presented characteristic imaging findings of MRONJ and ORN on scintigraphy, CT, and MR imaging. Our results suggest that CT can be effective for detecting MRONJ and ORN.
Keywords
Osteonecrosis; Tomography, X-Ray Computed; Radionuclide Imaging; Magnetic Resonance Imaging;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Paulo S, Abrantes AM, Laranjo M, Carvalho L, Serra A, Botelho MF, et al. Bisphosphonate-related osteonecrosis of the jaw: specificities. Oncol Rev 2014; 8: 254.   DOI
2 Koth VS, Figueiredo MA, Salum FG, Cherubini K. Bisphosphonate-related osteonecrosis of the jaw: from the sine qua non condition of bone exposure to a non-exposed BRONJ entity. Dentomaxillofac Radiol 2016; 45: 20160049.   DOI
3 Ruggiero SL. Diagnosis and staging of medication-related osteonecrosis of the jaw. Oral Maxillofac Surg Clin North Am 2015; 27: 479-87.   DOI
4 Ogura I, Sasaki Y, Kameta A, Sue M, Oda T. Characteristic multimodal imaging of medication-related osteonecrosis of the jaw: comparison between oral and parenteral routes of medication administration. Pol J Radiol 2017; 82: 551-60.   DOI
5 Bisdas S, Chambron Pinho N, Smolarz A, Sader R, Vogl TJ, Mack MG. Biphosphonate-induced osteonecrosis of the jaws: CT and MRI spectrum of findings in 32 patients. Clin Radiol 2008; 63: 71-7.   DOI
6 Chronopoulos A, Zarra T, Troltzsch M, Mahaini S, Ehrenfeld M, Otto S. Osteoradionecrosis of the mandible: a ten year single-center retrospective study. J Craniomaxillofac Surg 2015; 43: 837-46.   DOI
7 Chronopoulos A, Zarra T, Ehrenfeld M, Otto S. Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings. A concise review. Int Dent J 2018; 68: 22-30.   DOI
8 van de Meent MM, Pichardo SE, Rodrigues MF, Verbist BM, van Merkesteyn JP. Radiographic characteristics of chronic diffuse sclerosing osteomyelitis/tendoperiostitis of the mandible: a comparison with chronic suppurative osteomyelitis and osteoradionecrosis. J Craniomaxillofac Surg 2018; 46: 1631-6.   DOI
9 Hayama K, Tsuchimochi M, Yamaguchi H, Oda T, Sue M, Kameta A, et al. Dynamic analysis of technetium-99m HMDP accumulation and its effect on regional bone metabolism and bone blood flow in bisphosphonate-related osteonecrosis of the jaw. Oral Radiol 2013; 29: 135-9.   DOI
10 Hatakeyama H, Fujima N, Tsuchiya K, Mizoguchi K, Mizumachi T, Sakashita T, et al. Osteoradionecrosis of the hyoid bone after intra-arterial chemoradiotherapy for oropharyngeal cancer: MR imaging findings. Cancer Imaging 2017; 17: 22.   DOI
11 Ogura I, Sasaki Y, Kameta A, Sue M, Oda T. Diffusion-weighted imaging in the oral and maxillofacial region: usefulness of apparent diffusion coefficient maps and maximum intensity projection for characterization of normal structures and lesions. Pol J Radiol 2017; 82: 571-7.   DOI
12 Oda T, Sue M, Sasaki Y, Ogura I. Diffusion-weighted magnetic resonance imaging in oral and maxillofacial lesions: preliminary study on diagnostic ability of apparent diffusion coefficient maps. Oral Radiol 2018; 34: 224-8.   DOI
13 Morag Y, Morag-Hezroni M, Jamadar DA, Ward BB, Jacobson JA, Zwetchkenbaum SR, et al. Bisphosphonate-related osteonecrosis of the jaw: a pictorial review. Radiographics 2009; 29: 1971-84.   DOI
14 O'Ryan FS, Khoury S, Liao W, Han MM, Hui RL, Baer D, et al. Intravenous bisphosphonate-related osteonecrosis of the jaw: bone scintigraphy as an early indicator. J Oral Maxillofac Surg 2009; 67: 1363-72.   DOI
15 Leite AF, Ogata Fdos S, de Melo NS, Figueiredo PT. Imaging findings of bisphosphonate-related osteonecrosis of the jaws: a critical review of the quantitative studies. Int J Dent 2014; 2014: 784348.
16 Driessen JP, van Kempen PM, van der Heijden GJ, Philippens ME, Pameijer FA, Stegeman I, et al. Diffusion-weighted imaging in head and neck squamous cell carcinomas: a systematic review. Head Neck 2015; 37: 440-8.   DOI
17 Bonello L, Preda L, Conte G, Giannitto C, Raimondi S, Ansarin M, et al. Squamous cell carcinoma of the oral cavity and oropharynx: what does the apparent diffusion coefficient tell us about its histology? Acta Radiol 2016; 57: 1344-51.   DOI
18 Taniguchi T, Ariji Y, Nozawa M, Naitoh M, Kuroiwa Y, Kurita K, et al. Computed tomographic assessment of early changes of the mandible in bisphosphonate-treated patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122: 362-72.   DOI
19 Krishnan A, Arslanoglu A, Yildirm N, Silbergleit R, Aygun N. Imaging findings of bisphosphonate-related osteonecrosis of the jaw with emphasis on early magnetic resonance imaging findings. J Comput Assist Tomogr 2009; 33: 298-304.   DOI
20 Arce K, Assael LA, Weissman JL, Markiewicz MR. Imaging findings in bisphosphonate-related osteonecrosis of jaws. J Oral Maxillofac Surg 2009; 67 (5 Suppl): 75-84.