Bone involvement in chronic rhinosinusitis assessed by 99mTc-MDP bone SPECT

Area of Science:

• Otorhinolaryngology
• Nuclear Medicine
• Radiology

Background:

• Chronic rhinosinusitis (CRS) is a common condition affecting the nasal and sinus mucosa.
• The role of bone remodeling and inflammation in CRS pathogenesis remains incompletely understood.
• Assessing bony involvement may offer insights into disease severity and treatment response.

Purpose of the Study:

• To evaluate the clinical significance of bone involvement in patients with chronic rhinosinusitis.
• To correlate bone metabolism, assessed by bone scintigraphy, with CRS diagnosis and treatment outcomes.

Main Methods:

• Bone single photon emission computed tomography (SPECT) using 99mTc-MDP was performed on 43 patients with CRS.
• Quantitative isotope uptake indices were calculated and compared between CRS patients and controls.
• Uptake indices were also compared between patients with good and poor postoperative outcomes.

Main Results:

• Patients with CRS demonstrated significantly higher isotope uptake compared to the control group, indicating increased bone metabolism.
• Higher isotope uptake in the ethmoid sinus areas was observed in patients with poor postoperative outcomes.
• This suggests a correlation between the extent of bony involvement and treatment success.

Conclusions:

• Chronic rhinosinusitis is associated with significant bony involvement.
• Increased bone metabolism, particularly in the ethmoid sinuses, may serve as an indicator of more severe disease.
• Greater bony involvement appears to be linked to poorer treatment outcomes in CRS patients.