Imaging modalities for drug-related osteonecrosis of the jaw (3), Positron emission tomography imaging for the diagnosis of medication-related osteonecrosis of the jaw

Yoshimasa Kitagawa; Noritaka Ohga; Takuya Asaka; Jun Sato; Hironobu Hata; Joseph Helman; Kanako Tsuboi; Norio Amizuka; Yuji Kuge; Tohru Shiga

doi:10.1016/j.jdsr.2018.12.001

Imaging modalities for drug-related osteonecrosis of the jaw (3), Positron emission tomography imaging for the diagnosis of medication-related osteonecrosis of the jaw

Jpn Dent Sci Rev. 2019 Nov;55(1):65-70. doi: 10.1016/j.jdsr.2018.12.001. Epub 2019 Mar 15.

Authors

Yoshimasa Kitagawa¹, Noritaka Ohga¹, Takuya Asaka¹, Jun Sato¹, Hironobu Hata^{1

2}, Joseph Helman³, Kanako Tsuboi^{1

4}, Norio Amizuka⁴, Yuji Kuge⁵, Tohru Shiga⁶

Affiliations

¹ Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Japan.
² Dental and Oral Surgery, Hokkaido Cancer Center, Sapporo, Japan.
³ Oral and Maxillofacial Surgery, Department of Surgery, University of Michigan, United States.
⁴ Developmental Biology of Hard Tissue, Graduate School of Dental Medicine and Faculty of Dental Medicine, Hokkaido University, Japan.
⁵ Central Institute of Isotope Science, Hokkaido University, Japan.
⁶ Department of Nuclear Medicine, Graduate School of Dental Medicine, Hokkaido University, Japan.

Abstract

Medication-related osteonecrosis of jaws (MRONJ) is one of the most complicated inflammatory conditions in oral and maxillofacial region. It is very difficult to correctly evaluate the degree and extent of necrosis and infection. This refractory osteonecrosis often needs extended surgery, leading to impaired quality-of-life. We have performed hyperbaric oxygen therapy (HBO) combined with conservative surgery for advanced cases. We have appraised the value of FDG-PET and 3-phase bone scintigraphy in the diagnosis and management of this condition. MRONJ showed significantly higher SUV_max on FDG-PET than the others. Although the 3 phase pool bone images did not change significantly, perfusion and static bone image as well as PET showed remarkable response to HBO for MRONJ. SUV_max after HBO was significantly lower than those of before HBO. These preliminary results indicate that FDG-PET is useful for monitoring the effect of HBO for MRONJ.

Publication types

Review