Assessment of inflammatory jaw pathologies using bone SPECT/CT maximum standardized uptake value

Area of Science:

• Nuclear Medicine
• Radiology
• Oral and Maxillofacial Surgery

Background:

• Inflammatory jaw pathologies, including chronic osteomyelitis and medication-related osteonecrosis of the jaw (MRONJ), present diagnostic challenges.
• Accurate assessment is crucial for effective treatment planning and patient outcomes.

Purpose of the Study:

• To evaluate the diagnostic utility of bone single-photon emission CT-CT (SPECT/CT) maximum standardized uptake value (SUVmax) in differentiating inflammatory jaw pathologies.
• To compare SUVmax values across different types of inflammatory jaw conditions.

Main Methods:

• 44 patients with inflammatory jaw pathologies underwent bone SPECT/CT after ^99mTc hydroxymethylene diphosphonate injection.
• SUVmax values were analyzed for chronic osteomyelitis, osteoradionecrosis, and MRONJ.
• Statistical analysis using ANOVA with Tukey's test determined significance (p<0.05).

Main Results:

• The mean SUVmax for chronic osteomyelitis (24.94 ± 3.65) was significantly higher than for osteoradionecrosis (12.27 ± 5.47) and MRONJ (16.55 ± 9.12).
• Statistical significance was observed between chronic osteomyelitis and osteoradionecrosis (p=0.011) and between chronic osteomyelitis and MRONJ (p=0.043).

Conclusions:

• Bone SPECT/CT SUVmax, reflecting bone physiological changes, is significantly higher in chronic osteomyelitis compared to osteonecrosis (osteoradionecrosis and MRONJ).
• Bone SPECT/CT SUVmax demonstrates utility in assessing and differentiating inflammatory jaw pathologies.