{"title":"Fractal Analysis of Mandible in Panoramic Radiographs of Patients Received Radiotherapy for Nasopharyngeal Carcinoma","authors":"Rabia Duman Tepe , Kubra Ozkaya Toraman , Kivanc Bektas Kayhan , Ilknur Ozcan , Hulya Cakir Karabas","doi":"10.1016/j.jocd.2024.101531","DOIUrl":null,"url":null,"abstract":"<div><div><em>Purpose:</em> This study aimed to assess the impact of radiotherapy on the internal structure complexity of mandibular cortical and trabecular bone and to determine the duration required for a return to healthy values post-radiotherapy.</div><div><em>Materials and Methods:</em> Panoramic radiographs from patients undergoing radiotherapy for nasopharyngeal carcinoma were analyzed before and after treatment. Four groups were formed based on post-radiotherapy radiography timing (0-6 months, 6-12 months, 12-24 months, and 24-36 months), comprising a total of 59 cases and 118 radiographs. Fractal analysis was conducted on four bilateral regions (ROI) in both trabecular and cortical bone on each radiograph. Additionally, measurements of inferior alveolar canal width and mandibular cortical width were performed. Mean and maximum radiation dose values to the mandible were measured, and their correlation with changes in fractal dimension, inferior alveolar canal width, and mandibular cortical width values was assessed.</div><div><em>Results:</em> Fractal dimension values in regions over trabecular bone showed a statistically significant decrease in all groups, although no significant difference was observed among the four groups. In ROI-4 from cortical bone, a significant fractal dimension decrease was noted in all groups except the 0-6 month group. The magnitude of fractal dimension decrease was higher in the 12-24 and 24-36 month groups compared to the 0-6 month group. inferior alveolar canal width and mandibular cortical width values significantly decreased post-radiotherapy in all groups, with a consistent decrease across the groups.</div><div><em>Conclusions:</em> Radiotherapy induces a reduction in the internal complexity of trabecular and cortical bone structures in the mandible. Osteoradionecrosis risk persists even three years post-radiotherapy, suggesting a cautious approach to interventional procedures on the bone.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101531"},"PeriodicalIF":1.7000,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Densitometry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1094695024000659","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study aimed to assess the impact of radiotherapy on the internal structure complexity of mandibular cortical and trabecular bone and to determine the duration required for a return to healthy values post-radiotherapy.
Materials and Methods: Panoramic radiographs from patients undergoing radiotherapy for nasopharyngeal carcinoma were analyzed before and after treatment. Four groups were formed based on post-radiotherapy radiography timing (0-6 months, 6-12 months, 12-24 months, and 24-36 months), comprising a total of 59 cases and 118 radiographs. Fractal analysis was conducted on four bilateral regions (ROI) in both trabecular and cortical bone on each radiograph. Additionally, measurements of inferior alveolar canal width and mandibular cortical width were performed. Mean and maximum radiation dose values to the mandible were measured, and their correlation with changes in fractal dimension, inferior alveolar canal width, and mandibular cortical width values was assessed.
Results: Fractal dimension values in regions over trabecular bone showed a statistically significant decrease in all groups, although no significant difference was observed among the four groups. In ROI-4 from cortical bone, a significant fractal dimension decrease was noted in all groups except the 0-6 month group. The magnitude of fractal dimension decrease was higher in the 12-24 and 24-36 month groups compared to the 0-6 month group. inferior alveolar canal width and mandibular cortical width values significantly decreased post-radiotherapy in all groups, with a consistent decrease across the groups.
Conclusions: Radiotherapy induces a reduction in the internal complexity of trabecular and cortical bone structures in the mandible. Osteoradionecrosis risk persists even three years post-radiotherapy, suggesting a cautious approach to interventional procedures on the bone.
期刊介绍:
The Journal is committed to serving ISCD''s mission - the education of heterogenous physician specialties and technologists who are involved in the clinical assessment of skeletal health. The focus of JCD is bone mass measurement, including epidemiology of bone mass, how drugs and diseases alter bone mass, new techniques and quality assurance in bone mass imaging technologies, and bone mass health/economics.
Combining high quality research and review articles with sound, practice-oriented advice, JCD meets the diverse diagnostic and management needs of radiologists, endocrinologists, nephrologists, rheumatologists, gynecologists, family physicians, internists, and technologists whose patients require diagnostic clinical densitometry for therapeutic management.