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PT  - JOURNAL ARTICLE
AU  - Guggenberger, R.
AU  - Fischer, D.R.
AU  - Metzler, P.
AU  - Andreisek, G.
AU  - Nanz, D.
AU  - Jacobsen, C.
AU  - Schmid, D.T.
TI  - Bisphosphonate-Induced Osteonecrosis of the Jaw: Comparison of Disease Extent on Contrast-Enhanced MR Imaging, [&lt;sup&gt;18&lt;/sup&gt;F] Fluoride PET/CT, and Conebeam CT imaging
AID  - 10.3174/ajnr.A3355
DP  - 2012 Dec 06
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2012/12/06/ajnr.A3355.short
4100  - http://www.ajnr.org/content/early/2012/12/06/ajnr.A3355.full
AB  - BACKGROUND AND PURPOSE: Imaging of bisphosphonate-induced osteonecrosis of the jaw is essential for surgical planning. We compared the extent of BONJ on contrast-enhanced MR imaging, [18F] fluoride PET/CT, and panoramic views derived from standard conebeam CT with clinical pre- and intraoperative examinations. MATERIALS AND METHODS: Between February 2011 and January 2012, ten subjects with written informed consent (9 women; mean, 69.6 years; range, 53–88 years) were included in this prospective ethics-board-approved study. Patients underwent CEMR imaging, [18F] fluoride PET/CT, and CBCT and were clinically examined pre- and intraoperatively. Surgery was performed, and BONJ was histologically confirmed in 9 patients. Location and extent of BONJ on different modalities/examinations were graphically compared (0 = no pathologic finding, 1 = smallest, 5 = largest extent of BONJ). Rank tests were used to assess overall and paired differences of ratings in 9 patients. A P value &amp;lt;.05 was considered statistically significant. RESULTS: Significant differences in BONJ extent among different modalities and examinations were found (P &amp;lt; .001). The highest median rank was seen in PET/CT (4 ± 1.12) and CEMR imaging (4 ± 1.01), followed by intraoperative examinations (3 ± 0.71), CBCT (2 ± 0.33), and preoperative examinations (1 ± 0). No significant differences were found between PET/CT and CEMR imaging (P = .23), except when comparing PET/CT to either CBCT, pre- and intraoperative examinations (all P &amp;lt; .05). Preoperative examinations showed significantly less extensive disease than all other modalities/examinations (all P &amp;lt; .05). CONCLUSIONS: [18F] fluoride PET/CT and CEMR imaging revealed more extensive involvement of BONJ compared with panoramic views from CBCT and clinical examinations. Abbreviations BONJbisphosphonate-induced osteonecrosis of the jawCBCTconebeam CTCEMRcontrast-enhanced MRMDCTmultidetector CTSTIRshort τ inversion recovery