nach oben

Erschienen in:

19.12.2016 | Original Article

Bone scan index of the jaw: a new approach for evaluating early-stage anti-resorptive agents-related osteonecrosis

verfasst von: Satoru Watanabe, Kenichi Nakajima, Atsushi Mizokami, Hiroshi Yaegashi, Natsuyo Noguchi, Shuichi Kawashiri, Masafumi Inokuchi, Seigo Kinuya

Erschienen in: Annals of Nuclear Medicine | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Objective

A computer-aided diagnosis of bone scintigraphy using a bone scan index (BSI) has not been applied to a diagnosis of anti-resorptive agents-related osteonecrosis of the jaw (ARONJ). The aim of this study was to validate a diagnostic ability of BSI for early-stage ARONJ.

Methods

A total of 44 cancer patients treated with anti-resorptive drugs were evaluated retrospectively. All patients underwent bone scintigraphy and the tracer uptakes were analyzed by BSI. The software BONENAVI (FUJIFILM RI Pharma; EXINIbone, EXINI Diagnostics) could automatically detect abnormal intensities and calculate each regional BSI (rBSI). Among the rBSIs, the largest one in the jaw was manually selected and defined as maximum BSI of the jaw (BSIJmax). Uptake ratio (UR) between the maximum jaw count-to-average forehead count was also calculated. Screening accuracy of ARONJ based on 2 parameters was compared. Receiver operating characteristic analysis and Fisher’s exact test were performed.

Results

The BSIJmax was significantly higher in patients who developed ARONJ than in those who did not, 3 months before the diagnosis of stage 2 ARONJ (p < 0.0001 and p = 0.02 in the maxilla and mandible, respectively). Using the cutoff values of 0.09% in the maxilla and 0.06% in the mandible, BSIJmax for predicting stage 2 ARONJ showed sensitivity and specificity of 88 and 96%, respectively, in the maxilla and 64 and 89%, respectively, in the mandible at 3 months before the diagnosis. The BSIJmax >0.09% and BSIJmax >0.06% in the maxilla and mandible, respectively, were much more frequently observed in patients who subsequently developed stage 2 ARONJ 3 months after the bone scintigraphy than in those who did not (p < 0.0001 and odds ratio = 182 in the maxilla and p < 0.005 and odds ratio = 14 in the mandible). The UR showed comparable diagnostic ability.

Conclusion

The BSIJ provided a new index for evaluating ARONJ. For predicting occurrence of ARONJ, the thresholds of BSIJmax = 0.09 and 0.06% in the maxilla and mandible, respectively, may be used in patients treated with anti-resorptive drugs, and a differential diagnosis including ARONJ is recommended.

Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003;61:1115–7.CrossRefPubMed

Hellstein JW, Adler RA, Edwards B, Jacobsen PL, Kalmar JR, Koka S, et al. Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: executive summary of recommendations from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2011;142:1243–51.CrossRefPubMed

Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B, et al. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws–2009 update. J Oral Maxillofac Surg. 2009;67:2–12.CrossRefPubMed

Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw—2014 update. J Oral Maxillofac Surg. 2014;72:1938–56.CrossRefPubMed

Bedogni A, Fedele S, Bedogni G, Scoletta M, Favia G, Colella G, et al. Staging of osteonecrosis of the jaw requires computed tomography for accurate definition of the extent of bony disease. Br J Oral Maxillofac Surg. 2014;52:603–8.CrossRefPubMed

Schiodt M, Reibel J, Oturai P, Kofod T. Comparison of nonexposed and exposed bisphosphonate-induced osteonecrosis of the jaws: a retrospective analysis from the Copenhagen cohort and a proposal for an updated classification system. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117:204–13.CrossRefPubMed

Bedogni A, Fusco V, Agrillo A, Campisi G. Learning from experience. Proposal of a refined definition and staging system for bisphosphonate-related osteonecrosis of the jaw (BRONJ). Oral Dis. 2012;18:621–3.CrossRefPubMedPubMedCentral

Handmaker H, Leonards R. The bone scan in inflammatory osseous disease. Semin Nucl Med. 1976;6:95–105.CrossRefPubMed

Schauwecker DS. The scintigraphic diagnosis of osteomyelitis. AJR Am J Roentgenol. 1992;158:9–18.CrossRefPubMed

10.

Chiandussi S, Biasotto M, Dore F, Cavalli F, Cova MA, Di Lenarda R. Clinical and diagnostic imaging of bisphosphonate-associated osteonecrosis of the jaws. Dento maxillo facial radiology. 2006;35:236–43.CrossRefPubMed

11.

Arce K, Assael LA, Weissman JL, Markiewicz MR. Imaging findings in bisphosphonate-related osteonecrosis of jaws. J Oral Maxillofac Surg. 2009;67:75–84.CrossRefPubMed

12.

Krishnan A, Arslanoglu A, Yildirm N, Silbergleit R, Aygun N. Imaging findings of bisphosphonate-related osteonecrosis of the jaw with emphasis on early magnetic resonance imaging findings. J Comput Assist Tomogr. 2009;33:298–304.CrossRefPubMed

13.

O’Ryan FS, Khoury S, Liao W, Han MM, Hui RL, Baer D, et al. Intravenous bisphosphonate-related osteonecrosis of the jaw: bone scintigraphy as an early indicator. J Oral Maxillofac Surg. 2009;67:1363–72.CrossRefPubMed

14.

Thomas C, Spanidis M, Engel C, Roos FC, Frees S, Neisius A, et al. Bone scintigraphy predicts bisphosphonate-induced osteonecrosis of the jaw (BRONJ) in patients with metastatic castration-resistant prostate cancer (mCRPC). Clin Oral Investig. 2016;20:753–8.CrossRefPubMed

15.

Van den Wyngaert T, Huizing MT, Fossion E, Vermorken JB. Prognostic value of bone scintigraphy in cancer patients with osteonecrosis of the jaw. Clin Nucl Med. 2011;36:17–20.CrossRefPubMed

16.

Zanglis A, Andreopoulos D, Dima M, Baltas G, Baziotis N. Jaw uptake of technetium-99 methylene diphosphonate in patients on biphosphonates: a word of caution. Hell J Nucl Med. 2007;10:177–80.PubMed

17.

Dore F, Filippi L, Biasotto M, Chiandussi S, Cavalli F, Di Lenarda R. Bone scintigraphy and SPECT/CT of bisphosphonate-induced osteonecrosis of the jaw. J Nucl Med. 2009;50:30–5.CrossRefPubMed

18.

Hong CM, Ahn BC, Choi SY, Kim DH, Lee SW, Kwon TG, et al. Implications of three-phase bone scintigraphy for the diagnosis of bisphosphonate-related osteonecrosis of the jaw. Nucl Med Mol Imaging. 2012;46:162–8.CrossRefPubMedPubMedCentral

19.

Ohbayashi Y, Nakai F, Iwasaki A, Ogawa T, Yamamoto Y, Nishiyama Y, et al. The utility of bone scintigraphy in the assessment of mandibular metabolism during long-term bisphosphonate administration. Odontology. 2016. doi:10.1007/s10266-016-0279-9.PubMed

20.

Ohbayashi Y, Miyake M, Sawai F, Minami Y, Iwasaki A, Matsui Y. Adjunct teriparatide therapy with monitoring of bone turnover markers and bone scintigraphy for bisphosphonate-related osteonecrosis of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115:e31–7.CrossRefPubMed

21.

Ristow O, Gerngross C, Schwaiger M, Hohlweg-Majert B, Kehl V, Jansen H, et al. Is bone turnover of jawbone and its possible over suppression by bisphosphonates of etiologic importance in pathogenesis of bisphosphonate-related osteonecrosis? J Oral Maxillofac Surg. 2014;72:903–10.CrossRefPubMed

22.

Ristow O, Gerngross C, Schwaiger M, Hohlweg-Majert B, Ristow M, Koerdt S, et al. Does regular zoledronic acid change the bone turnover of the jaw in men with metastatic prostate cancer: a possible clue to the pathogenesis of bisphosphonate related osteonecrosis of the jaw? J Cancer Res Clin Oncol. 2014;140:487–93.CrossRefPubMed

23.

Ristow O, Gerngross C, Schwaiger M, Hohlweg-Majert B, Kehl V, Jansen H, et al. Effect of antiresorptive drugs on bony turnover in the jaw: denosumab compared with bisphosphonates. Br J Oral Maxillofac Surg. 2014;52:308–13.CrossRefPubMed

24.

Lapa C, Linz C, Bluemel C, Mottok A, Mueller-Richter U, Kuebler A, et al. Three-phase bone scintigraphy for imaging osteoradionecrosis of the jaw. Clin Nucl Med. 2014;39:21–5.CrossRefPubMed

25.

Sadik M, Suurkula M, Hoglund P, Jarund A, Edenbrandt L. Improved classifications of planar whole-body bone scans using a computer-assisted diagnosis system: a multicenter, multiple-reader, multiple-case study. J Nucl Med. 2009;50:368–75.CrossRefPubMed

26.

Nakajima K, Nakajima Y, Horikoshi H, Ueno M, Wakabayashi H, Shiga T, et al. Enhanced diagnostic accuracy for quantitative bone scan using an artificial neural network system: a Japanese multi-center database project. EJNMMI Res. 2013;3:83.CrossRefPubMedPubMedCentral

27.

Scher HI, Morris MJ, Larson S, Heller G. Validation and clinical utility of prostate cancer biomarkers. Nat Rev Clin Oncol. 2013;10:225–34.CrossRefPubMedPubMedCentral

28.

Erdi YE, Humm JL, Imbriaco M, Yeung H, Larson SM. Quantitative bone metastases analysis based on image segmentation. J Nucl Med. 1997;38:1401–6.PubMed

29.

Hutchinson M, O’Ryan F, Chavez V, Lathon PV, Sanchez G, Hatcher DC, et al. Radiographic findings in bisphosphonate-treated patients with stage 0 disease in the absence of bone exposure. J Oral Maxillofac Surg. 2010;68:2232–40.CrossRefPubMed

30.

Hamada H, Matsuo A, Koizumi T, Satomi T, Chikazu D. A simple evaluation method for early detection of bisphosphonate-related osteonecrosis of the mandible using computed tomography. J Craniomaxillofac Surg. 2014;42:924–9.CrossRefPubMed

31.

Taniguchi T, Ariji Y, Nozawa M, Naitoh M, Kuroiwa Y, Kurita K, et al. Computed tomographic assessment of early changes of the mandible in bisphosphonate-treated patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122:362–72.CrossRefPubMed

32.

Marx RE, Cillo JE Jr, Ulloa JJ. Oral bisphosphonate-induced osteonecrosis: risk factors, prediction of risk using serum CTX testing, prevention, and treatment. J Oral Maxillofac Surg. 2007;65:2397–410.CrossRefPubMed

33.

Lazarovici TS, Mesilaty-Gross S, Vered I, Pariente C, Kanety H, Givol N, et al. Serologic bone markers for predicting development of osteonecrosis of the jaw in patients receiving bisphosphonates. J Oral Maxillofac Surg. 2010;68:2241–7.CrossRefPubMed

34.

Ariji Y, Ariji E. Role of magnetic resonance imaging in diagnosis of bisphosphonate-related osteonecrosis of the jaw. Oral Radiol. 2013;29:111–20.CrossRef

35.

Kyrgidis A, Vahtsevanos K, Koloutsos G, Andreadis C, Boukovinas I, Teleioudis Z, et al. Bisphosphonate-related osteonecrosis of the jaws: a case-control study of risk factors in breast cancer patients. J Clin Oncol. 2008;26:4634–8.CrossRefPubMed

36.

Vahtsevanos K, Kyrgidis A, Verrou E, Katodritou E, Triaridis S, Andreadis CG, et al. Longitudinal cohort study of risk factors in cancer patients of bisphosphonate-related osteonecrosis of the jaw. J Clin Oncol. 2009;27:5356–62.CrossRefPubMed

37.

Nicolatou-Galitis O, Papadopoulou E, Sarri T, Boziari P, Karayianni A, Kyrtsonis MC, et al. Osteonecrosis of the jaw in oncology patients treated with bisphosphonates: prospective experience of a dental oncology referral center. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:195–202.CrossRefPubMed

38.

Van den Wyngaert T, Claeys T, Huizing MT, Vermorken JB, Fossion E. Initial experience with conservative treatment in cancer patients with osteonecrosis of the jaw (ONJ) and predictors of outcome. Ann Oncol. 2009;20:331–6.CrossRefPubMed

39.

Park HS, Lee YJ, Jeong SH, Kwon TG. Density of the alveolar and basal bones of the maxilla and the mandible. Am J Orthod Dentofac Orthop. 2008;133:30–7.CrossRef

40.

Kim HJ, Yu SK, Lee MH, Lee HJ, Kim HJ, Chung CH. Cortical and cancellous bone thickness on the anterior region of alveolar bone in Korean: a study of dentate human cadavers. J Adv Prosthodont. 2012;4:146–52.CrossRefPubMedPubMedCentral

41.

Jiang RF, Zhang L, Cheng B, Huang Z, Li DL, Wang MM, et al. Increased uptake of Tc-99m-methylene diphosphonate in the jaw. Clin Imaging. 2015;39:1068–72.CrossRefPubMed

42.

Arias JA, Pardo C, Olmos A, Cuadrado ML, Ruibal A. Dental diseases and radionuclide imaging of the jaws. Nucl Med Commun. 2004;25:305–10.CrossRefPubMed

43.

Abu-Id MH, Warnke PH, Gottschalk J, Springer I, Wiltfang J, Acil Y, et al. “Bis-phossy jaws”—high and low risk factors for bisphosphonate-induced osteonecrosis of the jaw. J Craniomaxillofac Surg. 2008;36:95–103.CrossRefPubMed

44.

Otto S, Schreyer C, Hafner S, Mast G, Ehrenfeld M, Sturzenbaum S, et al. Bisphosphonate-related osteonecrosis of the jaws—characteristics, risk factors, clinical features, localization and impact on oncological treatment. J Craniomaxillofac Surg. 2012;40:303–9.CrossRefPubMed

45.

Saad F, Brown JE, Van Poznak C, Ibrahim T, Stemmer SM, Stopeck AT, et al. Incidence, risk factors, and outcomes of osteonecrosis of the jaw: integrated analysis from three blinded active-controlled phase III trials in cancer patients with bone metastases. Ann Oncol. 2012;23:1341–7.CrossRefPubMed

46.

Hirshberg A, Buchner A. Metastatic tumours to the oral region. An overview. Euro J Cancer Part B. Oral Oncol. 1995;31b:355–60.

47.

Pruckmayer M, Glaser C, Marosi C, Leitha T. Mandibular pain as the leading clinical symptom for metastatic disease: nine cases and review of the literature. Ann Oncol. 1998;9:559–64.CrossRefPubMed

48.

Bedogni A, Saia G, Ragazzo M, Bettini G, Capelli P, D’Alessandro E, et al. Bisphosphonate-associated osteonecrosis can hide jaw metastases. Bone. 2007;41:942–5.CrossRefPubMed

49.

Sadik M, Suurkula M, Hoglund P, Jarund A, Edenbrandt L. Quality of planar whole-body bone scan interpretations—a nationwide survey. Eur J Nucl Med Mol Imaging. 2008;35:1464–72.CrossRefPubMed

50.

Tow DE, Garcia DA, Jansons D, Sullivan TM, Niederman R. Bone scan in dental diseases. J Nucl Med. 1978;19:845–7.PubMed

51.

Song JW, Oh YM, Shim TS, Kim WS, Ryu JS, Choi CM. Efficacy comparison between (18)F-FDG PET/CT and bone scintigraphy in detecting bony metastases of non-small-cell lung cancer. Lung Cancer (Amsterdam, Netherlands). 2009;65:333–8.CrossRef

52.

Hakim SG. Prognostic value of bone scintigraphy in cancer patients with osteonecrosis of the jaw: is there something missing? Clin Nucl Med. 2012;37:874.CrossRefPubMed

Titel: Bone scan index of the jaw: a new approach for evaluating early-stage anti-resorptive agents-related osteonecrosis
verfasst von: Satoru Watanabe
Kenichi Nakajima
Atsushi Mizokami
Hiroshi Yaegashi
Natsuyo Noguchi
Shuichi Kawashiri
Masafumi Inokuchi
Seigo Kinuya
Publikationsdatum: 19.12.2016
Verlag: Springer Japan
Erschienen in: Annals of Nuclear Medicine / Ausgabe 3/2017
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-016-1145-0

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Bone scan index of the jaw: a new approach for evaluating early-stage anti-resorptive agents-related osteonecrosis

Abstract

Objective

Methods

Results

Conclusion

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2017

Clinical correlation of metabolic parameters on 18F-FDG PET/CT in idiopathic frozen shoulder

Binding of 11C-Pittsburgh compound-B correlated with white matter injury in hypertensive small vessel disease

Research of predictive factors for cardiac resynchronization therapy: a prospective study comparing data from phase-analysis of gated myocardial perfusion single-photon computed tomography and echocardiography

Brain uptake and safety of Flutemetamol F 18 injection in Japanese subjects with probable Alzheimer’s disease, subjects with amnestic mild cognitive impairment and healthy volunteers

Aortic knob width reflects left ventricular diastolic function assessed by gated myocardial perfusion single photon emission computed tomography in patients with normal myocardial perfusion

An automated voxel-based method for calculating the reference value for a brain tumour metabolic index using 18F-FDG-PET and 11C-methionine PET