title: The role of Tc-99m phosphate complexes and gallium-67 in the diagnosis and management of maxillofacial disease: concise communication.
abstract: Osteomyelitis of maxillofacial bones is difficult to differentiate from the results of trauma or malignancy, yet successful management is dependent upon early diagnosis and appropriate therapy. To determined if gallium-67 could differentiate infection from trauma or malignancy, 61 Tc-99m phosphate scans and 52 gallium-67 scans were made in 42 patients with maxillofacial disease. In all patients, definitive diagnosis was determined by surgery and/or clinical followup. Bone scans were positive in 37 patients. Gallium-67 scans were positive in 16 patients. Subsequent surgery and/or clinical followup demonstrated active osteomyelitis in 15 patients. From the data we conclude that: (a) the addition of Ga-67 scanning to the bone scans in evaluation of maxillofacial disease contributes significantly to differentiating trauma from osteomyelitis; (b) radiographic changes do not accurately reflect bone activity or differentiate osteomyelitis from trauma or malignancy; and (c) reduction in accumulation of gallium-67 in followup scans is a useful indicator for the termination of therapy in osteomyelitis.
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005710:Gallium Radioisotopes; D006801:Humans; D007573:Jaw Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008336:Mandibular Diseases / Q000000981:diagnostic imaging*; D008439:Maxillary Diseases / Q000000981:diagnostic imaging*; D008446:Maxillofacial Injuries / Q000000981:diagnostic imaging; D010019:Osteomyelitis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013667:Technetium
chemical_list: D005710:Gallium Radioisotopes; D013667:Technetium