Browse > Article

CLINICAL EFFECTIVENESS OF BONE SCAN FOR DIFFERENTIAL DIAGNOSIS OF JAW LESION  

Kim, Jeong-Mo (Department of Oral & Maxillofacial Surgery, College of Dentistry, Dankook University)
Kim, Chul-Hwan (Department of Oral & Maxillofacial Surgery, College of Dentistry, Dankook University)
Publication Information
Maxillofacial Plastic and Reconstructive Surgery / v.29, no.1, 2007 , pp. 33-41 More about this Journal
Abstract
Bone scan using radioactive isotope can be more effective than conventional X-ray radiograph for finding jaw lesion because it takes an image of the physiologic change of bone. This study is designed to show how available bone scan is able to diagnose jaw lesion better than simple X-ray and CT, as well as to determine a basis of diagnosis for jaw lesion using bone scan. The 77 patients, visiting the Oral & Maxillofacial Surgery, Department of Dankook University Hospital from January 2002. to August 2005. who were diagnosed histopathologically with postoperative malignant tumor, osteomyelitis, and bone infiltrative benign disease. Preoperative X-ray, CT, bone scan were taken and were compared with histopathologic finding. Also to compare specificty of each lesion in bone scan, bone density was measured to compare. The results were as follows. 1. Among the 25 cases of oral malignant tumor of bony invasion, a positive diagnosis associated with histopathologic evaluation, 22 cases(88%) in bone scan, 14 cases(56%) in CT image, and 10 cases40%) in simple X-ray. 2. Among the 31 cases of osteomyelitis, a positive diagnosis associated with histopathologic evaluation, 30 cases(97%) in bone scan, 23 cases(74%) in CT image, and 19 cases(61%) in simple X-ray. 3. Among the 11cases of bone infiltrative benign disease, a positive diagnosis associated with histopathologic evaluation, 11 cases(100%) in bone scan, 10 cases(91%) in CT image, and 6 cases(55%) in simple X-ray. 4. Measurement of bone density in each group showed no statistical significant difference between malignant tumor and osteomyelitis as well as benign bone disease. But, a statistical significance was seen between osteomyelitis and benign bone disease. From this results, bone scan are more sensitive than simple X-ray and CT image in jaw lesion diagnosis, but specificity shows no significant difference. Therefore, it should be suggested that evaluation of bone scan must be carrying out in reference to final histopathologic diagnosis.
Keywords
Bone scan; Bone density; Jaw lesion;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Soderholm AL, Lindqvist C, Hietanen J et al : Bone scanning for evaluating mandibular bone extension of oral squamous cell carcinoma. J Oral Maxillofac Surg 48 : 252, 1990   DOI   ScienceOn
2 Koh CS : Nuclear medicine, 1st ed. Seoul, Korea Medical Book Publisher Co , 1992
3 Borak J : Relationship between the clinical and roentgeno-logical findings in bone metastases. Surg Gynecol Obstet 75 : 599, 1942
4 Belliveu RE, Spencer RP : Incidence and sites of bone lesions detected by 99mTc-polyphosphate scans in patients with tumors. Cancer 36 : 359, 1975   DOI   ScienceOn
5 Korean Association of Oral and Maxillofacial Surgeons : Oral and Maxillofacial Surgery, 2nd ed, Seoul Korea, Medical & Dental Publication Co., 1998, p.233
6 Green GS : Polyostotic fibrous dysplasia, Clin Nucl Med 9 : 600, 1984   DOI   PUBMED
7 Black RJ, Gluckman JL, Shumrick DA : Screening for distant metastases in head and neck cancer patients. Aust N Z J Surg 54 : 527, 1984   DOI   PUBMED
8 Powels TJ, Rosset G, Leese CL et al : Early morning hydroxyproline excretion in patients with breast cancer. Cancer 38 : 2564, 1976   DOI   ScienceOn
9 Lee SC : Oral Cancer. 1st ed, Seoul, KoonJa Publishing Co, 1993
10 Forcell H, Happonen RP, Forcell K et al : Osteochondroma of the mandibular condyle. Br J Oral Maxillofac Surg 23 : 183, 1985   DOI   ScienceOn
11 Baker HL, Woodbury DH, Krause CJ et al : Evaluation of bone scan by scintigraphy to detect subclinical invasion of the mandible by squamous cell carcinoma of oral cavity. Otolaryngol Head Neck Surg 90 : 327, 1982   PUBMED
12 Machida K, Makita K, Nishikawa J et al : Scintigraphic manifestation of fibrous dysplasia. Clin Nucl Med 11(6) : 426, 1986   DOI   PUBMED
13 Galasko CSB : Skeletal metastases. Clin Orthop Relat Res 210 : 18, 1986
14 Park HJ, Ryu SY : The Usefulness of bone scan for evaluating jaw bone extension of oral cancer. J Kor Oral Maxillofac Surg 26(6) : 658, 2000
15 Rosenthall L, Lisborna R : Malignant metastatic bone disease. Skeletal Imaging 53-74, Appleton-Century-Crofts, East Norwalk, Connecticut, 1984
16 Leipzig B : Assessment of mandibular invasion by carcinoma. Cancer 56 : 1201, 1985   DOI   PUBMED   ScienceOn
17 DeVita VT Jr, Hellman S, Rosenberg SA : Cancer, principles and practice of oncology, 5th ed. Philadelphia, New York, Lippincott-Raven, 1997, p.2570
18 Troell RJ, Terris DJ : Detection of metastases from head and neck cancers. Laryngoscope 105 : 247, 1995   DOI   ScienceOn
19 Myers EN, Suen JY : Cancer of the head and neck, 3rd ed. Philadelphia, Saunders, 1996
20 Tsuchimochi M, Higashino N, Okano A et al : Study of combined technetium 99m methylene diphosphonate and gallium 67 citrate scintigraphy in diffuse sclerosing osteomyelitis of the mandible : case reports. J Oral Maxillofac Surg 49(8) : 887, 1991   DOI   ScienceOn
21 Joo KB, Jeong EC, Lee JS : Efficacy of 99m Tc-MDP Bone Scan in the Diagnosis of Bone Metastases. Korean J Radiol. 24(1) : 117, 1988   DOI
22 Kim JH, Kim JS, Lee DS et al : Scintigraphic findings of fibrous dysplasia. Korean J Nucl Med 25(2) : 219, 1991
23 Citrin DL, Bessent RG, Greig WR : A comparison of the sensitivity and accuracy of the 99mTc-Phosphate bone scan and skeletal radiograph in the diagnosis of bone metastasis. Clin Radiol 28 : 107, 1977   DOI   ScienceOn
24 Worth HM : Principles and practive of oral radiologic interpretation. 1st ed, Chicago, Year book medical publishers, 1963, p.215
25 Herbosa EG, Rotskoff KS : Condylar osteochondroma manifesting as class III skeletal dysplasia. Am J Orthod Dentofac Orthop 100 : 472, 1991   DOI   ScienceOn
26 Thawley SE, Panje WR : Comprehensive management of head and neck tumors. Philadelphia. Saunders, 1987, p.460
27 Yoon HJ, Lee MC, Cho BY et al : 99mTc-MDP Bone Scan Findings in Various Clinical Stages of Malignancies. Korean J Nucl Med 15 : 149, 1981
28 Weisman RA, Kimmelman CP : Bone scanning in the assessment of mandibular invasion by oral cavity carcinomas. Laryngoscope 92 : 1, 1982   DOI   PUBMED   ScienceOn
29 Gilbert S, Tzadik A, Leonard G : Mandibular involvement by oral squamous cell carcinoma. J Cranio Maxillofac Surg 17 : 69, 1989   DOI
30 Goaz PW, White SC : Oral radiology. 1st ed, Saint Lohis, The C.V. Mosby Co., 1982, p.414