Pergolini Daniele, Mohsen Mohamed, Tenore Gianluca, Palaia Gaspare, Magnifico Lorenzo, Del Vecchio Alessandro, Romeo Umberto
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy.
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161, Rome, Italy.
Open Med (Wars). 2025 Feb 18;20(1):20251143. doi: 10.1515/med-2025-1143. eCollection 2025.
The aim of this study is to evaluate the bone scintigraphy (BS) and positron emission tomography (PET) in the early diagnosis of medication-related osteonecrosis of the jaws (MRONJ) and their possible use in the identification of patients at risk for MRONJ.
Thirty-one patients treated with ONJ-related drugs and who had undergone BS or PET for the evaluation of bone lesions were included in the study. The jaws of each patient were divided into four areas. For each area, the presence of pathological tracer uptake was evaluated and related to the eventual MRONJ development. Sensitivity, specificity, and predictive values of both techniques were determined. The latency from the finding of pathological tracer uptake in BS or PET to the clinical diagnosis of MRONJ and the odds ratio were also calculated.
Sensitivity and specificity of BS for MRONJ prediction were, respectively, 83.3 and 87.5%. Positive and negative predictive values were, respectively, 73.2 and 92.8%. The odds ratio was 35. Sensitivity of PET was 33.3%, specificity was 94.9%, and positive and negative predictive values were 70.0 and 80.0%, respectively. The odds ratio was 9.333. All values were statistically significant.
BS and PET may be accurate techniques for an early prediction of MRONJ.
本研究旨在评估骨闪烁显像（BS）和正电子发射断层扫描（PET）在药物相关性颌骨坏死（MRONJ）早期诊断中的应用，以及它们在识别MRONJ高危患者方面的潜在用途。
本研究纳入了31例接受过与ONJ相关药物治疗且已接受BS或PET检查以评估骨病变的患者。将每位患者的颌骨分为四个区域。对于每个区域，评估病理性示踪剂摄取情况，并将其与最终的MRONJ发展情况相关联。确定了两种技术的敏感性、特异性和预测值。还计算了从BS或PET中发现病理性示踪剂摄取到MRONJ临床诊断的潜伏期以及比值比。
BS预测MRONJ的敏感性和特异性分别为83.3%和87.5%。阳性和阴性预测值分别为73.2%和92.8%。比值比为35。PET的敏感性为33.3%，特异性为94.9%，阳性和阴性预测值分别为70.0%和80.0%。比值比为9.333。所有值均具有统计学意义。
BS和PET可能是早期预测MRONJ的准确技术。
