Potential role of post‑treatment follow‑up FDG‑PET CT to detect mandibular osteoradionecrosis: A case report

Akashi,Masaya; Wanifuchi,Satoshi; Kusumoto,Junya; Kishimoto,Megumi; Kakei,Yasumasa; Hashikawa,Kazunobu; Komori,Takahide

doi:10.3892/mco.2017.1477

January-2018 Volume 8 Issue 1

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

January-2018 Volume 8 Issue 1

Full Size Image

Case Report Open Access

Potential role of post‑treatment follow‑up FDG‑PET CT to detect mandibular osteoradionecrosis: A case report

Authors:
- Masaya Akashi
- Satoshi Wanifuchi
- Junya Kusumoto
- Megumi Kishimoto
- Yasumasa Kakei
- Kazunobu Hashikawa
- Takahide Komori
View Affiliations / Copyright

Affiliations: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan, Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650‑0017, Japan

Copyright: © Akashi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 61-67
|
Published online on: November 2, 2017

https://doi.org/10.3892/mco.2017.1477
Expand metrics +

Abstract

It was hypothesized that fluorodeoxyglucose (FDG) uptake on post‑treatment follow‑up positron emission tomography with computed tomography (PET CT; using PET CT to monitor and rule out recurrence and metastasis of head and neck carcinoma) would be useful for detecting and understanding the disease state of osteoradionecrosis (ORN) of the jaw. The present study included 14 patients who developed mandibular ORN following radiation therapy (RT) for head and neck cancer and underwent follow‑up PET CT several times following RT. Areas exhibiting FDG uptake were retrospectively assessed on post‑treatment follow‑up PET CT images and were classified into three types: Spot type: Only spot accumulation of FDG; localized type: Accumulation of FDG restricted to within the bone resorption area; extensive type: Accumulation of FDG extending into surrounding soft tissue. PET classification at the time of clinical diagnosis of mandibular ORN in the 14 patients demonstrated the extensive type in 43%, localized type in 36% and spot type in 21%. An increased area of FDG uptake around the ORN was revealed retrospectively on post‑treatment follow‑up FDG PET‑CT images in 50% of patients. Alterations in PET classification included spot type to localized type in 36% and localized type to extensive type in 14%. A significantly increased number of patients with extensive‑type ORN (P=0.026) required surgery. Post‑treatment follow‑up FDG‑PET CT may be useful for early detection and better understanding of ORN.

View Figures

View References

1	Maesschalck T, Dulguerov N, Caparrotti F, Scolozzi P, Picardi C, Mach N, Koutsouvelis N and Dulguerov P: Comparison of the incidence of osteoradionecrosis with conventional radiotherapy and intensity-modulated radiotherapy. Head Neck. 38:1695–1702. 2016. View Article : Google Scholar : PubMed/NCBI
2	Wanifuchi S, Akashi M, Ejima Y, Shinomiya H, Minamikawa T, Furudoi S, Otsuki N, Sasaki R, Nibu KI and Komori T: Cause and occurrence timing of osteoradionecrosis of the jaw: A retrospective study focusing on prophylactic tooth extraction. Oral Maxillofac Surg. 20:337–342. 2016. View Article : Google Scholar : PubMed/NCBI
3	Jacobson AS, Buchbinder D, Hu K and Urken ML: Paradigm shifts in the management of osteoradionecrosis of the mandible. Oral Oncol. 46:795–801. 2010. View Article : Google Scholar : PubMed/NCBI
4	Store G and Larheim TA: Mandibular osteoradionecrosis: A comparison of computed tomography with panoramic radiography. Dentomaxillofac Radiol. 28:295–300. 1999. View Article : Google Scholar : PubMed/NCBI
5	Fleisher KE, Raad RA, Rakheja R, Gupta V, Chan KC, Friedman KP, Mourtzikos KA, Janal M and Glickman RS: Fluorodeoxyglucose positron emission tomography with computed tomography detects greater metabolic changes that are not represented by plain radiography for patients with osteonecrosis of the jaw. J Oral Maxillofac Surg. 72:1957–1965. 2014. View Article : Google Scholar : PubMed/NCBI
6	Hakim SG, Bruecker CW, H Ch Jacobsen, Hermes D, Lauer I, Eckerle S, Froehlich A and Sieg P: The value of FDG-PET and bone scintigraphy with SPECT in the primary diagnosis and follow-up of patients with chronic osteomyelitis of the mandible. Int J Oral Maxillofac Surg. 35:809–816. 2006. View Article : Google Scholar : PubMed/NCBI
7	De Winter F, Vogelaers D, Gemmel F and Dierckx RA: Promising role of 18-F-fluoro-D-deoxyglucose positron emission tomography in clinical infectious diseases. Eur J Clin Microbiol Infect Dis. 21:247–257. 2002. View Article : Google Scholar : PubMed/NCBI
8	Demirev A, Weijers R, Geurts J, Mottaghy F, Walenkamp G and Brans B: Comparison of [18 F]FDG PET/CT and MRI in the diagnosis of active osteomyelitis. Skeletal Radiol. 43:665–672. 2014. View Article : Google Scholar : PubMed/NCBI
9	Wahl MJ: Osteoradionecrosis prevention myths. Int J Radiat Oncol Biol Phys. 64:661–669. 2006. View Article : Google Scholar : PubMed/NCBI
10	Nabil S and Samman N: Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: A systematic review. Int J Oral Maxillofac Surg. 40:229–243. 2011. View Article : Google Scholar : PubMed/NCBI
11	Fleisher KE, Pham S, Raad RA, Friedman KP, Ghesani M, Chan KC, Amintavakoli N, Janal M, Levine JP and Glickman RS: Does fluorodeoxyglucose positron emission tomography with computed tomography facilitate treatment of medication-related osteonecrosis of the jaw? J Oral Maxillofac Surg. 74:945–958. 2016. View Article : Google Scholar : PubMed/NCBI
12	Annane D, Depondt J, Aubert P, Villart M, Géhanno P, Gajdos P and Chevret S: Hyperbaric oxygen therapy for radionecrosis of the jaw: A randomized, placebo-controlled, double-blind trial from the ORN96 study group. J Clin Oncol. 22:4893–4900. 2004. View Article : Google Scholar : PubMed/NCBI
13	Robard L, Louis MY, Blanchard D, Babin E and Delanian S: Medical treatment of osteoradionecrosis of the mandible by PENTOCLO: preliminary results. Eur Ann Otorhinolaryngol Head Neck Dis. 131:333–338. 2014. View Article : Google Scholar : PubMed/NCBI
14	Shemesh S, Kosashvili Y, Groshar D, Bernstine H, Sidon E, Cohen N, Luria T and Velkes S: The value of 18-FDG PET/CT in the diagnosis and management of implant-related infections of the tibia: A case series. Injury. 46:1377–1382. 2015. View Article : Google Scholar : PubMed/NCBI
15	Alhilali L, Reynolds AR and Fakhran S: Osteoradionecrosis after radiation therapy for head and neck cancer: Differentiation from recurrent disease with CT and PET/CT imaging. AJNR Am J Neuroradiol. 35:1405–1411. 2014. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Potential role of post‑treatment follow‑up FDG‑PET CT to detect mandibular osteoradionecrosis: A case report

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Related Articles