ΔBSIJ: a quantitative marker for early detection of medication-related osteonecrosis of the jaw in patients with prostate cancer receiving bone-modifying agents.
IF 2.5 4区 医学Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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引用次数: 0
Abstract
Objective: Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of bone-modifying agent (BMA) therapy in patients with prostate cancer and bone metastasis. This study aimed to assess the effectiveness of the temporal changes in jaw-specific bone scan index (ΔBSIJ) as quantitative markers for early prediction of MRONJ in patients with prostate cancer receiving BMA therapy.
Methods: This retrospective study included 33 patients with prostate cancer with bone metastases who underwent bone scintigraphy before and after BMA initiation. BSIJ was measured using BONENAVI software, and the difference between pre- and post-BMA BSIJ values was considered ΔBSIJ. Statistical analyses, including paired t-test, receiver operating characteristic (ROC) curve analysis, and Kaplan-Meier survival estimate, were employed to assess the predictive value of ΔBSIJ for MRONJ.
Results: Of the 33 patients, 10 developed MRONJ during a median follow-up period of 29 months. ΔBSIJ was significantly higher in the MRONJ group than in the non-MRONJ group (0.05 vs. - 0.04, p = 0.002). ROC analysis revealed the highest area under the curve (AUC = 0.823) for ΔBSIJ compared with the pre- and post-BMA BSIJ values. A ΔBSIJ cutoff of 0.039 predicted MRONJ with 60% sensitivity and 91% specificity. Patients with ΔBSIJ ≥ 0.039 exhibited significantly shorter MRONJ-free survival than those with ΔBSIJ < 0.039 (median: 18.4 months vs. not reached, p < 0.001).
Conclusion: ΔBSIJ is a novel and clinically useful quantitative marker for the early detection of MRONJ in patients with prostate cancer receiving BMA therapy. This study highlights the potential of leveraging functional imaging and temporal changes in BSIJ to improve MRONJ management.
目的：药物相关性颌骨坏死（MRONJ）是骨修饰剂（BMA）治疗前列腺癌及骨转移患者的严重并发症。本研究旨在评估颌骨特异性骨扫描指数（ΔBSIJ）的时间变化作为早期预测接受BMA治疗的前列腺癌患者MRONJ的定量标志物的有效性。方法：回顾性研究33例前列腺癌骨转移患者，在BMA启动前后行骨显像检查。BSIJ使用BONENAVI软件测量，bma前后BSIJ值的差异考虑ΔBSIJ。采用配对t检验、受试者工作特征（ROC）曲线分析、Kaplan-Meier生存估计等统计分析评估ΔBSIJ对MRONJ的预测价值。结果：在33例患者中，10例在中位随访29个月期间发生MRONJ。ΔBSIJ在MRONJ组显著高于非MRONJ组（0.05 vs. - 0.04, p = 0.002）。ROC分析显示，与bma前后的BSIJ值相比，ΔBSIJ的曲线下面积最大（AUC = 0.823）。预测MRONJ的ΔBSIJ截止值为0.039，灵敏度为60%，特异性为91%。ΔBSIJ≥0.039的患者无MRONJ生存期明显短于ΔBSIJ的患者。结论：ΔBSIJ是前列腺癌BMA治疗患者MRONJ早期检测的一种新颖的、临床有用的定量标志物。这项研究强调了利用BSIJ的功能成像和时间变化来改善MRONJ管理的潜力。
期刊介绍：
Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine.
The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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