title: (18)F-FDG accumulation in the oral cavity is associated with periodontal disease and apical periodontitis: an initial demonstration on PET/CT.
abstract: OBJECTIVE
  The objective of this study was to prospectively investigate the relationship between high accumulation of 2-deoxy-2-[(18)F] fluoro-D: -glucose (FDG) in the oral cavity and dental infections on positron emission tomography/computed tomography (PET/CT).
  
  
  METHODS
  FDG-PET/CT scans of 103 patients who underwent a health screening were evaluated. The dental examination was performed prior to each PET/CT scan, and dental infections were assessed. Dental infections were classified into six blocks. The severity of dental caries was classified into five grades, and periodontal disease and apical periodontitis were classified into three grades. Two radiologists classified the PET images in the same manner as the dental examination. They evaluated the intensity of FDG uptake by a four-point visual PET image score for each block. The comparison of the dental examination, as a gold standard, and the visual PET image score was performed on a patient or block basis.
  
  
  RESULTS
  On a patient-based analysis, 21 of 103 patients (20.4%) showed PET positive findings in the oral cavity; 18 of the 21 patients (85.7%) had dental infections. On a block-based analysis, 25 of 605 blocks (4.1%) showed PET positive findings in the oral cavity; 22 of the 25 blocks (88.0%) had dental infections. On a detailed block-based analysis, a significant difference was observed between the presence of periodontal disease, or apical periodontitis and the positivity of the visual PET image findings (P < 0.01). Their severity correlated with the visual PET image score (P < 0.05).
  
  
  CONCLUSIONS
  Periodontal disease or apical periodontitis, but not dental caries, caused FDG accumulation in the oral cavity. This finding should be taken into account when a head and neck FDG-PET study is interpreted.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimamoto
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Tatsumi
authors.forename: Naoya
authors.initials: N
authors.lastname: Kakimoto
authors.forename: Seiki
authors.initials: S
authors.lastname: Hamada
authors.forename: Eku
authors.initials: E
authors.lastname: Shimosegawa
authors.forename: Shumei
authors.initials: S
authors.lastname: Murakami
authors.forename: Souhei
authors.initials: S
authors.lastname: Furukawa
authors.forename: Jun
authors.initials: J
authors.lastname: Hatazawa