Positron-emission tomography imaging in the diagnosis of bisphosphonate-related osteonecrosis of the jaw

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Mar;107(3):412-9. doi: 10.1016/j.tripleo.2008.09.019. Epub 2009 Jan 4.

Abstract

Objectives: The purpose of this study was to investigate the sensitivity of F-18 fluoride and F-18 fluorodeoxyglucose (FDG) positron-emission tomography (PET) in the diagnosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ), and to test their suitability for assessing the severity of BRONJ.

Study design: Nine patients with BRONJ were studied using F-18 fluoride and F-18 FDG PET. For analysis, 8 regions of interest (ROI) were defined in the jaws of each patient. Maximum count rates for each ROI in both PET examinations were analyzed.

Results: In both studies, increased tracer enhancement was observed in regions with BRONJ. Uptake of fluoride significantly exceeded that of FDG. FDG uptake increased systematically, but not significantly, with increasing severity of BRONJ.

Conclusion: F-18 fluoride PET is a sensitive method for diagnosis of BRONJ. FDG PET could be useful for evaluation of the severity of BRONJ. Further studies are required to prove the specificity of the methods.

Publication types

  • Evaluation Study

MeSH terms

  • Bone Density Conservation Agents / adverse effects*
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / secondary
  • Diphosphonates / adverse effects*
  • Female
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Humans
  • Imidazoles / adverse effects*
  • Jaw Diseases / chemically induced
  • Jaw Diseases / diagnostic imaging*
  • Male
  • Osteonecrosis / chemically induced
  • Osteonecrosis / diagnostic imaging*
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Zoledronic Acid

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Fluorine Radioisotopes
  • Imidazoles
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Zoledronic Acid