title: Clinical utility of fluoride-18 positron emission tomography/CT in temporomandibular disorder with osteoarthritis: comparisons with 99mTc-MDP bone scan.
abstract: OBJECTIVE
  The purpose of this study was to compare the clinical utility of fluoride-18 positron emission tomography (¹⁸F-PET)/CT with that of conventional (99m)Tc-methylene diphosphonate (MDP) bone scan in temporomandibular disorder (TMD) with osteoarthritis.
  
  
  METHODS
  24 patients with TMD who underwent both ¹⁸F-PET/CT and (99m)Tc-MDP bone scans for diagnostic work-up were enrolled. The temporomandibular joint (TMJ)-to-skull uptake ratio, TMJ-to-muscle uptake ratio and TMJ-to-spine uptake ratio on ¹⁸F-PET/CT and the TMJ uptake ratio on bone scan were measured.
  
  
  RESULTS
  Of the 48 TMJs in 24 patients, 35 TMJs were diagnosed as TMD with osteoarthritis, 8 TMJs as TMD with anterior disc displacement (ADD), and the remaining 5 TMJs showed no evidence of TMD (NED). All three uptake ratios on ¹⁸F-PET/CT and the TMJ uptake ratio on the bone scan tended to be higher in TMD with osteoarthritis than in TMD with ADD or NED. Receiver operating characteristic (ROC) curve analysis for detecting TMD with osteoarthritis indicated that the TMJ-to-skull uptake ratio, TMJ-to-muscle uptake ratio and TMJ-to-spine uptake ratio on PET/CT (0.819, 0.771 and 0.813, respectively) showed higher area under the ROC curve value than the TMJ ratio on bone scan (0.714). The TMJ-to-skull uptake ratio on PET/CT showed the highest sensitivity (89%) and accuracy (81%) of all uptake ratios.
  
  
  CONCLUSIONS
  ¹⁸F-PET/CT can help diagnose TMD with osteoarthritis with superior diagnostic ability and is a suitable alternative modality to a conventional (99m)Tc-MDP bone scan.
authors: Department of Nuclear Medicine, Jeju National University Hospital, Republic of Korea.
authors: J W
authors: JW
authors: Lee
authors: S M
authors: SM
authors: Lee
authors: S-J
authors: SJ
authors: Kim
authors: J-W
authors: JW
authors: Choi
authors: K-W
authors: KW
authors: Baek
mesh_terms: D000328:Adult; D019540:Area Under Curve; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D010003:Osteoarthritis / Q000000981:diagnostic imaging*; D010294:Parietal Bone / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods* / Q000706:statistics & numerical data; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate; D013701:Temporal Bone / Q000000981:diagnostic imaging; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013669:Technetium Tc 99m Medronate
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