Norikazu Matsutomo    Department   Kawasaki University of Medical Welfare  ,    Position   Associate Professor with Special Assignment
Article types	原著
Language	English
Peer review	Peer reviewed
Title	Pilot study of a novel resection extent determination method using bone single-photon emission computed tomography-standardized uptake value in medication-related osteonecrosis of the jaw.
Journal	Formal name：Dento maxillo facial radiology Abbreviation：Dentomaxillofac Radiol ISSN code：1476542X/0250832X
Domestic / Foregin	Foregin
Volume, Issue, Page	54(6),pp.495-501
Author and coauthor	Naoya Hayashi, Norikazu Matsutomo, Ryotaro Tokorodani, Mitsuha Fukami, Miki Nishimori, Kie Nakatani, Yukio Yoshioka, Yoshihiro Hayashi, Ichiro Murakami, Takuji Yamagami, Tetsuya Yamamoto, Tomoaki Yamamoto
Publication date	2025/04
Summary	OBJECTIVE:Surgery is the standard treatment for medication-related osteonecrosis of the jaw (MRONJ). However, there are few reports on the appropriate extent of the bone resection. This pilot study explores the feasibility of a new method for estimating the extent of resection using bone single-photon emission computed tomography (SPECT)-standardized uptake value (SUV).METHODS:We retrospectively analyzed 8 MRONJ patients who underwent curettage (n = 2), curettage with removal of the separated sequestrum (n = 2), or marginal resection (n = 4) as part of extensive surgery. The resected regions were compared with the regions estimated using SPECT-SUV. The agreement between the SPECT cold region and the resected region was evaluated using the Dice coefficient (defined as the ratio of 2 × overlap volume to resected volume plus SPECT cold region volume), overlap ratio, and volume ratio. The inclusion of CT findings (osteolytic, gap- and irregular-type periosteal reactions, and mixed-type osteosclerosis) in the estimated region was also evaluated. Additionally, histopathological findings from 3 marginal resection cases were used to validate the estimated region.RESULTS:In all cases, the resected region included the cold regions observed on bone SPECT, with radiotracer accumulation confirmed around the resected region. CT-osteolytic regions were included within the estimated region. The Dice coefficient was 0.53 ± 0.10, the overlap ratio was 86.7 ± 7.2%, and the volume ratio was 235.0 ± 74.7%. Histopathological analysis revealed significant osteocyte necrosis in cold regions, whereas areas with an SUV of 9 displayed normal osteocytes, newly formed bone, and mild inflammatory cell infiltration.CONCLUSION:This study suggests that the setting of the SPECT-cold region using bone SPECT-SUV may allow for the estimation of the extent of resection in early-to-intermediate-stage MRONJ.
DOI	10.1093/dmfr/twaf032
PMID	40233239