Histopathological findings affect quantitative values of single photon emission computed tomography in patients with antiresorptive agent-related osteonecrosis of the jaws.

Fujita Medical Journal Pub Date : 2023-08-01 DOI:10.20407/fmj.2022-025

Taro Okui, Yoshikazu Kobayashi, Madoka Isomura, Masakazu Tsujimoto, Koji Satoh, Hiroshi Toyama

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Abstract

Objectives: This study investigated the relationships between quantitative values calculated from bone single photon emission computed tomography/computed tomography (SPECT/CT) images and histopathological findings observed in surgical specimens from patients with antiresorptive agent-related osteonecrosis of the jaw (ARONJ); it sought to clarify histopathological factors that cause accumulation in bone SPECT/CT images of patients with ARONJ.

Methods: This study included 81 pathological specimens of 21 lesions obtained from 18 patients with ARONJ who underwent SPECT/CT and jaw resection. The maximum standardized uptake value (SUV_max) of each volume of interest of the specimens was calculated using RAVAT^® software. The ratio of the SUV_max to the mean value of SUV_max in temporal bone was termed rSUV_max. The rSUV_max and pathological findings (sequestration, degree of fibrosis, degree of trabecular bone destruction, degree of inflammatory cell infiltration, and vascularity) were compared using the Mann-Whitney U test and the Kruskal-Wallis test.

Results: In univariate analysis with rSUV_max as the dependent variable, the pathological findings of sequestration (P=0.058), degree of fibrosis (P=0.810), degree of trabecular bone destruction (P=0.237), degree of inflammatory cell infiltration (P=0.120), and vascularity (P=0.111) showed no significant difference among the groups for each variable.

Conclusions: We found no association between quantitative values in bone SPECT/CT and histological changes in ARONJ, probably because bone SPECT/CT has limited spatial resolution. Limitations of this study may include the imaging findings of a decrease in tracer accumulation because of an involucrum of necrosed bone, various histopathological findings in ARONJ, and failure to consider the effect of preoperative anti-inflammatory treatment.

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组织病理学结果影响抗吸收剂相关颌骨骨坏死患者单光子发射计算机断层扫描的定量值。

目的:探讨骨单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)图像计算的定量值与抗吸收剂相关性颌骨骨坏死(ARONJ)患者手术标本的组织病理学结果之间的关系;它试图阐明导致ARONJ患者骨SPECT/CT图像中积聚的组织病理学因素。方法:对18例ARONJ患者行SPECT/CT及颌部切除术的21个病变81份病理标本进行研究。使用RAVAT®软件计算各感兴趣体积标本的最大标准化摄取值(SUVmax)。颞骨的SUVmax与SUVmax平均值之比称为rSUVmax。采用Mann-Whitney U试验和Kruskal-Wallis试验比较rSUVmax和病理结果(隔离、纤维化程度、骨小梁破坏程度、炎症细胞浸润程度和血管状况)。结果:在以rSUVmax为因变量的单因素分析中，各变量组间隔离(P=0.058)、纤维化程度(P=0.810)、骨小梁破坏程度(P=0.237)、炎症细胞浸润程度(P=0.120)、血管通畅(P=0.111)的病理表现均无显著差异。结论:我们发现骨SPECT/CT的定量值与ARONJ的组织学变化没有关联，可能是因为骨SPECT/CT的空间分辨率有限。本研究的局限性可能包括由于坏死骨的内翻导致示踪剂积累减少的影像学结果，ARONJ的各种组织病理学结果，以及未考虑术前抗炎治疗的效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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