Gallium-67 SPECT-CT for the evaluation of head and neck: preliminary study on maximum standardised uptake value in lesions, and in the parotid and submandibular glands.

PURPOSE: The aim of this study was to investigate the gallium-67 (67Ga) single-photon emission-computed tomography (SPECT-CT) for the evaluation of head and neck, especially maximum standardised uptake value (SUVmax) in lesions, and in the parotid and submandibular glands. MATERIAL AND METHODS: Fourteen patients with head and neck lesions who underwent SPECT-CT at 72 hours after injection of 67Ga were included in this study. The 67Ga SPECT-CT parameters SUVmax were compared between the parotid glands and submandibular glands. Statistical analyses for the SUVmax were performed by Mann-Whitney U test. A p value lower than 0.05 was considered as statistically significant. RESULTS: Of all 14 patients, 67Ga SPECT-CT was positive for two cases (one malignant lymphoma and one osteomyelitis). The SUVmax for malignant lymphoma and osteomyelitis were 11.21 and 10.95, respectively. Furthermore, SUVmax for parotid glands and submandibular glands of all patients were 4.86 ± 1.89 and 4.64 ± 1.64, respectively (p = 0.694). CONCLUSIONS: This study investigated the 67Ga SPECT-CT for the evaluation of head and neck, especially SUVmax of lesions, and the parotid and submandibular glands. 67Ga SPECT-CT may be an effective technique for the evaluation of maxillofacial lesions.

Characteristics of patients with temporomandibular joint osteoarthrosis on magnetic resonance imaging.

INTRODUCTION: Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The aim of this study was to investigate the characteristics of the patients with TMJ osteoarthrosis on MR imaging. METHODS: The MR images of 206 TMJs of 103 patients with temporomandibular disorders (TMD) were evaluated retrospectively in this study. The relationship between osteoarthrosis and age, gender, TMJ pain and MR imaging findings, such as disc displacement with or without reduction and TMJ effusion, was analysed. RESULTS: The patients with TMJ osteoarthrosis (mean: 51.6 years) were significantly older than those without osteoarthrosis (mean: 44.8 years, P = 0.027). The incidence of the patients with TMJ osteoarthrosis was significantly different between with (10.0 %) and without reduction (57.0 %, P < 0.001). Logistic multivariate regression analysis demonstrated that disc displacement without reduction was significant in patients with TMJ osteoarthrosis (odds ratio = 12.285, P < 0.001). CONCLUSIONS: This study suggests that characteristics of the patients with TMJ osteoarthrosis on MR imaging include older and disc displacement without reduction.

Assessment of inflammatory jaw pathologies using bone SPECT/CT maximum standardized uptake value.

OBJECTIVES: To investigate the assessment of inflammatory jaw pathologies using bone single-photon emission CT-CT (SPECT/CT) maximum standardized uptake value (SUVmax). METHODS: 44 patients with inflammatory jaw pathologies (7 chronic osteomyelitis, 8 osteoradionecrosis and 29 medication-related osteonecrosis of the jaw (MRONJ)) underwent SPECT/CT at 4 h after injection of 99mTc hydroxymethylene diphosphonate. The SPECT/CT parameters SUVmax of the inflammatory jaw pathologies were analyzed. Statistical analyses for the SUVmax were performed by one-way repeated measures analysis of variance with Tukey's honestly significant difference test. A p-value lower than 0.05 was considered statistically significant. RESULTS: The mean and standard deviation of SUVmax for 7 chronic osteomyelitis, 8 osteoradionecrosis and 29 MRONJ were 24.94 ± 3.65, 12.27 ± 5.47 and 16.55 ± 9.12, respectively. The SUVmax for chronic osteomyelitis were significantly higher than those for osteoradionecrosis (p = 0.011) and MRONJ (p = 0.043). CONCLUSIONS: Bone SPECT/CT SUVmax in the uptake of 99mTc hydroxymethylene diphosphonate reflecting bone physiological changes for chronic osteomyelitis were significantly higher than those of osteonecrosis, such as osteoradionecrosis and MRONJ. Bone SPECT/CT SUVmax should be useful for the assessment of inflammatory jaw pathologies, such as chronic osteomyelitis, osteoradionecrosis and MRONJ.

Strain elastography of palatal tumors in conjunction with intraoral ultrasonography, computed tomography, and magnetic resonance imaging: 2 case reports.

Computed tomography (CT) and magnetic resonance imaging (MRI) can be useful for the evaluation of palatal lesions, and strain elastography (performed together with intraoral ultrasonography) is a relatively new sonographic imaging modality. This report describes 2 clinical cases in which strain elastography was used to assess palatal tumors in conjunction with intraoral ultrasonography, CT, and MRI. In the first case, diagnosed as a myoepithelioma, the strain was determined to be 0.000% (strain of normal tissue, 0.556%). In the second case, diagnosed as an adenoid cystic carcinoma, the determined strain was 0.000% (strain of normal tissue, 1.077%). Therefore, we conclude that intraoral strain elastography can be useful for evaluating palatal lesions.

Quantitative SPECT/CT imaging for medication-related osteonecrosis of the jaw: a preliminary study using volume-based parameters, comparison with chronic osteomyelitis.

OBJECTIVE: To investigate the quantitative SPECT/CT imaging for medication-related osteonecrosis of the jaw (MRONJ) using volume-based parameters. METHODS: Thirteen patients with mandibular lesions (nine MRONJ and four chronic osteomyelitis) underwent SPECT/CT acquisition at 4 h after injection of technetium 99m hydroxymethylene diphosphonate. Then, reconstruction of the acquired data and underwent voxel-based quantitative analysis using GI-BONE software. The parameters of the quantitative manner, such as maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), mean SUV (SUVmean), metabolic bone volume (MBV) and total bone uptake (TBU), were compared for the mandibular lesions. Statistical analyses for the quantitative parameters of mandibular lesions were performed by Mann-Whitney U test. A p value lower than 0.05 was considered as statistically significant. RESULTS: Then, reconstruction of these quantitative parameters, SUVmax (10.16 ± 0.96), SUVpeak (7.95 ± 0.88), SUVmean (5.90 ± 0.86) and TBU (94.22 ± 57.44) for chronic osteomyelitis were significantly higher than those for MRONJ [5.50 ± 2.47 (p = 0.020), 4.10 ± 1.85 (p = 0.011), 2.74 ± 1.07 (p = 0.006) and 29.88 ± 15.46 (p = 0.034), respectively]. CONCLUSIONS: SUVmax, SUVpeak, SUVmean and TBU derived from bone SPECT/CT and voxel-based quantitative parameters may be useful for the evaluation of mandibular lesions, such as MRONJ and chronic osteomyelitis.