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Risk assessment of osteoradionecrosis associated with periodontitis using 18F-FDG PET/CT.

Abstract：

PURPOSE:Osteoradionecrosis (ORN) is a serious complication after radiotherapy (RT), even in the era of intensity modulated radiation therapy (IMRT). The purpose of this study was to evaluate whether 18F-FDG PET/CT can predict ORN associated with periodontal disease in patients with oropharyngeal or oral cavity squamous cell carcinoma (OP/OC SCC) undergoing RT. METHODS:One hundred and five OP/OC SCC patients treated with RT who underwent pretreatment 18F-FDG PET/CT between October 2007 and June 2016 were retrospectively reviewed. A post-treatment diagnosis of ORN was made clinically based on presence of exposed irradiated mandibular bone that failed to heal after a period of three months without persistent or recurrent tumor. The maximum standardized uptake value (SUVmax) of periodontal regions identified on PET/CT was measured for all patients. Image-based staging of periodontitis was also performed using American Academy of Periodontology staging system on CT. RESULTS:Among 105 patients, 14 (13.3 %) developed ORN. The SUVmax of the periodontal region in patients with ORN (3.35 ± 1.23) was significantly higher than patients without ORN (1.92 ± 0.66) (P <  .01). The corresponding CT stage of periodontitis in patients with ORN was significantly higher (2.71±0.47) than patients without ORN (1.80±0.73) (P <  .01). ROC analysis revealed the cut-off values of developing ORN were 2.1 in SUVmax, and II in CT stage of periodontitis. The corresponding AUC was 0.86 and 0.82, respectively. CONCLUSIONS:Pretreatment 18F-FDG PET/CT identification of periodontitis may be helpful to predict the future development of ORN in patients with OP/OC SCC undergoing RT.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Ito K,Takumi K,Meibom SK,Qureshi MM,Fujima N,Andreu-Arasa VC,Truong MT,Salama AR,Kaneda T,Sakai O

doi

10.1016/j.ejrad.2020.109259

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

109259

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(20)30448-4

journal_volume

132

pub_type

杂志文章

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