Medication-Related Osteonecrosis of the Jaw—Comparison of Bone Imaging Using Ultrashort Echo-Time Magnetic Resonance Imaging and Cone-Beam Computed Tomography

医学 锥束ct 磁共振成像 颌骨骨坏死 核医学 放射科 双膦酸盐相关性颌骨骨坏死 计算机断层摄影术 骨质疏松症 双膦酸盐 病理
作者
Florian A. Huber,Paul Schumann,Jochen von Spiczak,Moritz C. Wurnig,Markus Klarhöfer,Tim Finkenstaedt,Alberto Bedogni,Roman Guggenberger
出处
期刊:Investigative Radiology [Lippincott Williams & Wilkins]
卷期号:55 (3): 160-167 被引量:22
标识
DOI:10.1097/rli.0000000000000617
摘要

Objective The aim of this study was to compare bone imaging between ultrashort echo-time (UTE) magnetic resonance (MR) imaging and cone-beam computed tomography (CBCT) as the reference standard in patients with medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods A 1-year retrospective, blinded, and randomized qualitative analysis of UTE MR images and CBCT from 19 patients with clinically diagnosed MRONJ was performed by 2 independent radiologists. Medication-related osteonecrosis of the jaw imaging hallmarks such as osteolysis, periosteal thickening, and medullary osteosclerosis were rated visually (0 and 1 to 3 for normal and mild to severe changes) for defined anatomic regions of the jaw. In addition, segmentation of these regions was performed on coregistered MR/CBCT images for the following quantitative comparison of signal intensity (SI) on MR and gray values (GVs) on CBCT images. Interreader/modality agreement (Cohen kappa), standard testing for significant differences of (non)parametric values, and Pearson correlation of signal intensity/GV were used for statistical analysis. Results The anterior corpus of the mandible was most often affected by MRONJ ( P < 0.001). Overall, interreader agreement of qualitative MRONJ hallmark scores was almost perfect (κ = 0.81) and without significant differences between modalities (κ = 0.81 vs 0.82, CBCT vs MR, respectively). Intermodality agreement for qualitative gradings was substantial for both readers (κ = 0.77 and 0.70). Signal intensity/GV in MRONJ-affected areas differed significantly from healthy bone ( P < 0.001) as well as correlation significantly between modalities ( r = −0.77; P < 0.001). Conclusions Qualitative assessment of MRONJ with radiation-free UTE MR imaging is comparable to reference standard CBCT. Quantitative measurements of both modalities significantly distinguish diseased from normal bone with strong correlations among the quantitative values in both modalities.
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