Quantitative bone scan imaging using BSI and BUV: an approach to evaluate ARONJ early

Area of Science:

• Nuclear Medicine
• Radiology
• Oncology

Background:

• Anti-resorptive-agent-related osteonecrosis of the jaw (ARONJ) is a potential complication of treatments for bone metastasis.
• Early detection of ARONJ is crucial for effective management.
• Quantitative metrics from bone scintigraphy are being explored for improved diagnostic capabilities.

Purpose of the Study:

• To validate the diagnostic ability of bone scan index (BSI) for early detection of ARONJ.
• To assess the added value of bone uptake value (BUV) in improving ARONJ detection.
• To evaluate the combined diagnostic performance of BSI and BUV.

Main Methods:

• Retrospective analysis of 34 patients treated with anti-resorptive agents for bone metastasis.
• Quantitative analysis of jaw uptake using BONENAVI software for BSIJ and BUV software for BUVJ.
• Comparison of BSIJ and BUVJ values between ARONJ positive and negative groups.

Main Results:

• Mean BSIJ values were significantly higher in ARONJ positive (0.17±0.83%) versus negative (0.03±0.50%) groups.
• Mean BUVJ values were significantly higher in ARONJ positive (0.47±0.17) versus negative (0.19±0.11) groups.
• The area under the curve (AUC) for BSIJ×BUVJ (0.988) was superior to BSIJ (0.949) and BUVJ (0.951) alone.

Conclusions:

• Bone scan index (BSI) is a valuable tool for the early detection of ARONJ.
• Incorporating bone uptake value (BUV) enhances the diagnostic accuracy of BSI for ARONJ.
• SPECT imaging is recommended for mandibles with high BSIJ and BUVJ on bone scintigraphy.