Department of Radiology and Interventional Radiology, Kanagawa Cancer Center, 2-2-2 Nakao Asahi-Ku, Yokohama City, Kanagawa, Japan, 241-8515.
Department of Oral and Maxillofacial Surgery, Kanagawa Cancer Center, 2-2-2 Nakao Asahi-Ku, Yokohama City, Kanagawa, Japan, 241-8515.
Ann Nucl Med. 2020 Jan;34(1):74-79. doi: 10.1007/s12149-019-01417-x. Epub 2019 Nov 8.
The usefulness of bone scan index (BSI), a quantitative metric of the area of uptake in computer-aided diagnosis in bone scintigraphy, has been reported for the diagnosis of anti-resorptive-agent-related osteonecrosis of the jaw (ARONJ). The aim of this study is to validate the diagnostic ability of BSI for the early detection of ARONJ. In addition, the Bone uptake value (BUV), another quantitative index obtained from bone scintigraphy that indicates the degree of radioisotope (RI) accumulation, was used to improve the diagnostic ability for early detection of ARONJ.
A total of 34 patients (11 with ARONJ, 23 without ARONJ) who were administered anti-resorptive-agents for bone metastasis and had incidentally consulted a dental surgeon within 3 months after regular whole-body bone scintigraphy were retrospectively included in the study. The bone scintigraphy data were subjected to semiquantitative analysis of uptake in the jaw using BONENAVI (FUJIFILM Toyama Chemical, Co. Ltd., Tokyo, Japan; EXINI Diagnostics AB, Lund, Sweden) and BUV software (Technical Society for Quantitative Bone Scintigraphy and Fujifilm Toyama Chemical Co., Ltd. Tokyo, Japan). The ROI was set semi-automatically on mandibular hotspots, and the regional BSI was termed BSIJ. Planar anterior and posterior images were then sent to BUV software, with the ROI set manually as for BSI, and the regional BUV was termed BUVJ.
Mean BSIJ values for the ARONJ positive and ARONJ negative groups were 0.17 ± 0.83 and 0.03 ± 0.50%, respectively. Mean BUVJ values for the ARONJ positive and ARONJ negative groups were 0.47 ± 0.17 and 0.19 ± 0.11, respectively. BSIJ × BUVJ values for the ARONJ positive versus ARONJ negative groups were 0.088 ± 0.067 vs. 0.007 ± 0.010. The AUC for BSIJ, BUVJ and BSIJ × BUVJ was 0.949, 0.951 and 0.988, respectively.
The BSI metric of a CAD system for bone scintigraphy was useful for the early detection of ARONJ. Accuracy was improved with the additional use of BUVJ data. We recommend that SPECT imaging be performed when bone scintigraphy reveals focal or diffuse uptake in the mandible with high BSIJ and BUVJ.
骨扫描指数（BSI）是计算机辅助诊断中骨闪烁照相术摄取面积的定量指标，已被报道可用于诊断抗吸收剂相关的颌骨坏死（ARONJ）。本研究旨在验证 BSI 对早期检测 ARONJ 的诊断能力。此外，还使用了另一种从骨闪烁照相术获得的定量指数——骨摄取值（BUV），该指数表示放射性同位素（RI）的积累程度，以提高早期检测 ARONJ 的诊断能力。
回顾性纳入 34 例（11 例 ARONJ，23 例无 ARONJ）接受抗吸收剂治疗骨转移并在常规全身骨闪烁照相后 3 个月内偶然咨询牙医的患者。使用 BONENAVI（FUJIFILM Toyama Chemical，Co.，Ltd.，东京，日本；EXINI Diagnostics AB，隆德，瑞典）和 BUV 软件（定量骨闪烁照相技术学会和富士胶片托亚马化学有限公司，东京，日本）对颌骨摄取进行半定量分析。ROI 半自动设置在下颌热点，局部 BSI 称为 BSIJ。然后将平面前后图像发送到 BUV 软件，ROI 手动设置为 BSI，局部 BUV 称为 BUVJ。
ARONJ 阳性和 ARONJ 阴性组的平均 BSIJ 值分别为 0.17±0.83%和 0.03±0.50%。ARONJ 阳性和 ARONJ 阴性组的平均 BUVJ 值分别为 0.47±0.17 和 0.19±0.11。ARONJ 阳性与 ARONJ 阴性组的 BSIJ×BUVJ 值分别为 0.088±0.067 和 0.007±0.010。BSIJ、BUVJ 和 BSIJ×BUVJ 的 AUC 分别为 0.949、0.951 和 0.988。
骨闪烁照相术 CAD 系统的 BSI 指标可用于早期检测 ARONJ。与 BUVJ 数据联合使用可提高准确性。当骨闪烁照相术显示下颌骨有高 BSIJ 和 BUVJ 的局灶性或弥漫性摄取时，建议进行 SPECT 成像。
