Process of Hard Palate Osteonecrosis Demonstrated on Serial 18F-FDG PET/CT Scans

Osteonecrosis of the hard palate is rare. Here, we demonstrated the dynamic metabolic and structural changes during the process of osteonecrosis of the hard palate by serial 18F-FDG PET/CT scans in a patient with nasal NK/T-cell lymphoma. On the baseline scan, increased FDG uptake in the periphery of the hard palate could be observed. On the following scans after treatment, a focal metabolic defect on the hard palate with no structural changes and with bone sequestration and perforation have been observed successively. Our case indicates that the metabolic defect on 18F-FDG PET/CT may be an early sign of osteonecrosis.