薬剤関連顎骨壊死のPET検査

Positron-emission tomography imaging in the diagnosis of medication-related osteonecrosis of the jaw

慢性顎骨骨髄炎は今日の診断，治療法の発展にもかかわらず，口腔顎顔面領域の炎症性病変の中では最も難治性の疾患の一つである。

Medication-related osteonecrosis of jaws（MRONJ）is one of the most complicated inflammatory conditions in oral and maxillofacial region. It is very difficult to correctly evaluate the degree and extent of necrosis and infection. This refractory osteonecrosis often needs extended surgery, leading to impaired quality-of-life. We have performed hyperbaric oxygen therapy（HBO）combined with conservative surgery for advanced cases. We have appraised the value of FDG-PET and 3-phase bone scintigraphy in the diagnosis and management of this condition. MRONJ showed significantly higher SUVmax on FDG-PET than the others. Although the 3 phase pool bone images did not change significantly, perfusion and static bone image as well as PET showed remarkable response to HBO for MRONJ. SUVmax after HBO was significantly lower than those of before HBO. These preliminary results indicate that FDG-PET is useful for monitoring the effect of HBO for MRONJ.