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Harmonization of Quantitative Values in Bone SPECT/CT for Medication-Related Osteonecrosis of the Jaw

  • 0Graduate School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan.
Journal of Nuclear Medicine Technology +

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August 26, 2025

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August 26, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Harmonizing quantitative SPECT/CT (Q-SPECT/CT) improves medication-related osteonecrosis of the jaw (MRONJ) diagnosis. A software-based approach reduces scanner variability, enabling reliable multicenter studies for MRONJ detection.

Area Of Science

  • Nuclear Medicine
  • Medical Imaging
  • Oncology

Background

  • Medication-related osteonecrosis of the jaw (MRONJ) significantly impacts patient quality of life.
  • Accurate MRONJ diagnosis is crucial due to increased use of antiresorptive and antiangiogenic agents.
  • Quantitative SPECT/CT (Q-SPECT/CT) shows promise for MRONJ detection, but inter-scanner variability hinders multicenter research.

Purpose Of The Study

  • To establish harmonization criteria for Q-SPECT/CT in MRONJ diagnosis.
  • To evaluate a software-based approach for harmonizing Q-SPECT/CT data across different scanners.
  • To reduce inter-scanner variability in quantitative measurements for multicenter MRONJ studies.

Main Methods

  • A multicenter phantom study using a custom brain tumor phantom with 6 hot spheres and <sup>99m</sup>Tc-hydroxymethylene diphosphonate.
  • SPECT/CT imaging performed at 7 institutions on 8 scanners following clinical protocols.
  • Software-based analysis for SUV conversion, region of interest analysis, and harmonization using a median SUV<sub>max</sub> ± 30% criterion with Gaussian filtering.

Main Results

  • Background SUV<sub>mean</sub> remained consistent (0.95-1.05) before and after harmonization, showing minimal interscanner differences.
  • Inter-scanner variability for hot spheres significantly improved: SUV<sub>max</sub> coefficient of variation reduced from 122% to 48%, SUV<sub>peak</sub> from 68% to 35%, and SUV<sub>mean</sub> from 71% to 37%.
  • The software-based harmonization effectively reduced variability without compromising image quality or requiring additional reconstruction.

Conclusions

  • A novel harmonization criterion for Q-SPECT/CT in MRONJ was identified.
  • The software-based harmonization approach successfully reduces inter-scanner variability in Q-SPECT/CT for MRONJ.
  • This method supports the feasibility and reliability of multicenter clinical studies for MRONJ detection and staging.

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