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KMID : 1148920120460030162
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Nuclear Medicine and Molecular Imaging
2012 Volume.46 No. 3 p.162 ~ p.168
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Implications of Three-Phase Bone Scintigraphy for the Diagnosis of Bisphosphonate-Related Osteonecrosis of the Jaw
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Hong Chae-Moon
Ahn Byeong-Cheol
Choi So-Young
Kim Do-Hoon
Lee Sang-Woo
Kwon Tae-Geon
Lee Jae-Tae
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Abstract
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Purpose: Bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) is a well-known serious complication of BP treatment. This study was undertaken to evaluate the diagnostic usefulness of three-phase bone scintigraphy in patients with BRONJ.
Methods: Forty-one patients (48 lesions) with clinically proven BRONJ (2 males, 39 females, age 74.3?±?6.7 years) underwent Tc-99 m HDP bone scintigraphy. Visual interpretation and semiquantitative analysis of uptakes using lesion-to-contralateral uptake ratios during the blood pool phase (BUR) and during the osseous phase (OUR) were performed, and relations were sought between these and various clinical parameters.
Results: Three-phase bone scintigraphy showed increased perfusion and blood pooling in 21 (63.6 %) and 27 (81.8 %) of 33 lesions, respectively. The osseous phase was positive for 45 (93.8 %) of the 48 lesions. Of the four inflammatory clinical parameters of BRONJ [pus discharge, pain, swelling, and erythrocyte sedimentation rate (ESR)], patients with three or more parameters had more positive findings in vascular and blood pool phase images (p?=?0.033, p?=?0.027). By semiquantitative analysis, patients with a positive ESR had statistically higher BUR and OUR (both p?
Conclusions: Bone scintigraphy provides a relatively sensitive means of detecting BRONJ, so it was helpful for accurate BRONJ staging. Furthermore, increased uptakes in vascular and blood pool phases of three-phase bone scintigraphy were related to the inflammatory activity of BRONJ.
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KEYWORD
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Three-phase bone scintigraphy, Bisphosphonate, Osteonecrosis, Jaws
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