Abstract
1526
Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction caused of antiresorptive and antiangiogenic drugs. Pre-existing dental or periodontal disease is considered one of the risk factors of MRONJ. The purpose of this study was to investigate the usefulness of 18F-FDG PET/CT in early detection and potential risk assessment in patients with MRONJ. Materials and Methods: A total of 11 patients who had undergone 18F-FDG PET/CT scan over 6 months before diagnosing MRONJ were included in this study. The jaws of each patient were divided into 4 regions (right maxillary, left maxillary, right mandible and left mandible). The 18F-FDG PET/CT images were visually and semiquantitatively evaluated. For visual analysis, focal avid 18F-FDG uptake was interpreted as positive. For semiquantitative analysis, in positive case, the maximal standardized uptake value (SUVmax) of the lesion was measured. In negative case, the mean SUV of the jaw was measured.
Results: Of the 44 regions in 11 patients, 15 regions were clinically diagnosed of MRONJ. One patient had 3 regions, 2 patients had 2 regions and 8 patients had 1 region. Of 15 regions with MRONJ, 12 regions (80%) were positive on 18F-FDG PET/CT. Of 29 regions without MRONJ, 8 regions (27.6%) were positive. The mean ± SD value of SUVmax in regions with MRONJ (5.58 ± 2.06) was significantly higher than that in regions without MRONJ (3.16 ± 0.71) (p<0.001).
Conclusions: These preliminary results indicated that focal 18F-FDG uptake in jaws may be a predictor of MRONJ.