Positron-emission tomography imaging in the diagnosis of bisphosphonate-related osteonecrosis of the jaw.
OBJECTIVE
The purpose of this study was to investigate the sensitivity of F-18 fluoride and F-18 fluorodeoxyglucose (FDG) positron-emission tomography (PET) in the diagnosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ), and to test their suitability for assessing the severity of BRONJ.


METHODS
Nine patients with BRONJ were studied using F-18 fluoride and F-18 FDG PET. For analysis, 8 regions of interest (ROI) were defined in the jaws of each patient. Maximum count rates for each ROI in both PET examinations were analyzed.


RESULTS
In both studies, increased tracer enhancement was observed in regions with BRONJ. Uptake of fluoride significantly exceeded that of FDG. FDG uptake increased systematically, but not significantly, with increasing severity of BRONJ.


CONCLUSIONS
F-18 fluoride PET is a sensitive method for diagnosis of BRONJ. FDG PET could be useful for evaluation of the severity of BRONJ. Further studies are required to prove the specificity of the methods.
Wilde
Frank
F
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University of Leipzig, Leipzig, Germany. frank.wilde@medizin.uni-leipzig.de
Steinhoff
Karen
K
Frerich
Bernhard
B
Schulz
Thomas
T
Winter
Karsten
K
Hemprich
Alexander
A
Sabri
Osama
O
Kluge
Regine
R
D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D007571:Jaw Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging*; D008297:Male; D010020:Osteonecrosis / Q000139:chemically induced / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005462:Fluorine Radioisotopes; D007093:Imidazoles; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000077211:Zoledronic Acid