Quantitative SPECT/CT imaging for medication-related osteonecrosis of the jaw: a preliminary study using volume-based parameters, comparison with chronic osteomyelitis

Objective To investigate the quantitative SPECT/CT imaging for medication-related osteonecrosis of the jaw (MRONJ) using volume-based parameters. Methods Thirteen patients with mandibular lesions (nine MRONJ and four chronic osteomyelitis) underwent SPECT/CT acquisition at 4 h after injection of technetium 99m hydroxymethylene diphosphonate. Then, reconstruction of the acquired data and underwent voxel-based quantitative analysis using GI-BONE software. The parameters of the quantitative manner, such as maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), mean SUV (SUVmean), metabolic bone volume (MBV) and total bone uptake (TBU), were compared for the mandibular lesions. Statistical analyses for the quantitative parameters of mandibular lesions were performed by Mann-Whitney U test. A p value lower than 0.05 was considered as statistically significant. Results Then, reconstruction of these quantitative parameters, SUVmax ( 10.16 +/- 0.96), SUVpeak (7.95 +/- 0.88), SUVmean (5.90 +/- 0.86) and TBU (94.22 +/- 57.44) for chronic osteomyelitis were significantly higher than those for MRONJ [5.50 +/- 2.47 (p = 0.020), 4.10 +/- 1.85 (p = 0.011), 2.74 +/- 1.07 (p = 0.006) and 29.88 +/- 15.46 (p = 0.034), respectively]. Conclusions SUVmax, SUVpeak, SUVmean and TBU derived from bone SPECT/CT and voxel-based quantitative parameters may be useful for the evaluation of mandibular lesions, such as MRONJ and chronic osteomyelitis.