title: Maximum Standardized Uptake Value of (99m)Tc Hydroxymethylene Diphosphonate SPECT/CT for the Evaluation of Temporomandibular Joint Disorder.
abstract: Purpose To evaluate the diagnostic accuracy of the quantitative parameter standardized uptake value (SUV) at single photon emission computed tomography (SPECT)/computed tomography (CT) for the evaluation of temporomandibular joint (TMJ) disorder (TMD). Materials and Methods This study was approved by the institutional review board, and the need for informed consent was waived. Forty-four TMJs in 22 patients with TMD (five men and 17 women; mean age ± standard deviation, 30.0 years ± 12.1) were evaluated. The patients underwent planar bone scintigraphy and SPECT/CT 3-4 hours after injection of technetium 99m hydroxymethylene diphosphonate. The planar scintigraphy parameter of relative ratio (RR) and SPECT/CT parameters mean SUV (SUVmean) and maximum SUV (SUVmax) were compared for the visual assessment of TMD on planar scintigraphy images and for the presence of TMJ arthralgia. Group comparisons, receiver operating characteristic analysis, and Pearson correlation analysis were conducted. Results SUVmax gradually increased from normal (2.82 ± 0.73) to mild or moderately abnormal (3.56 ± 0.76, P < .05) and then to severely abnormal (4.86 ± 1.25, P < .05). However, RR and SUVmean did not vary significantly according to visual grade (P > .05). On the other hand, SUVmax was significantly greater in arthralgic TMJs (4.15 ± 1.11) than in nonarthralgic TMJs (2.97 ± 0.75, P < .001), as was SUVmean (1.63 ± 0.42 vs 1.30 ± 0.31, respectively; P = .005). However, there was no significant difference in RR (3.61 ± 0.57 vs 3.76 ± 0.68, P = .45). In receiver operating characteristic curve analyses for arthralgic TMJ, SUVmax had the greatest area under the curve (area of 0.815). Conclusion SUVmax derived from bone SPECT/CT may be useful for the evaluation of TMD. (©) RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea (M.S.S., W.W.L., S.E.K.); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea (W.W.L.); and Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seoul, South Korea (Y.K.K., P.Y.Y.).
authors.forename: Min Seok
authors.initials: MS
authors.lastname: Suh
authors.affiliation: From the Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea (M.S.S., W.W.L., S.E.K.); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea (W.W.L.); and Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seoul, South Korea (Y.K.K., P.Y.Y.).
authors.forename: Won Woo
authors.initials: WW
authors.lastname: Lee
authors.affiliation: From the Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea (M.S.S., W.W.L., S.E.K.); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea (W.W.L.); and Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seoul, South Korea (Y.K.K., P.Y.Y.).
authors.forename: Young-Kyun
authors.initials: YK
authors.lastname: Kim
authors.affiliation: From the Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea (M.S.S., W.W.L., S.E.K.); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea (W.W.L.); and Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seoul, South Korea (Y.K.K., P.Y.Y.).
authors.forename: Pil-Young
authors.initials: PY
authors.lastname: Yun
authors.affiliation: From the Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea (M.S.S., W.W.L., S.E.K.); Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea (W.W.L.); and Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seoul, South Korea (Y.K.K., P.Y.Y.).
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D000072098:Single Photon Emission Computed Tomography Computed Tomography; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate