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Clinical Oral Investigations

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01-12-2019 | Computed Tomography | Original Article

Comparative evaluation of SPECT/CT and CBCT in patients with mandibular osteomyelitis and osteonecrosis

Authors: Johann Malina-Altzinger, Bernd Klaeser, Valerie G.A. Suter, Martina Schriber, Bernd Vollnberg, Benoit Schaller

Published in: Clinical Oral Investigations | Issue 12/2019

Abstract

Objectives

Therapy of osteomyelitis and osteonecrosis very often requires surgery. Proper preoperative radiological evaluation of a lesion’s localization and extent is a key in planning surgical bone resection. This study aims to assess the differences between single-photon emission computed tomography and cone beam computed tomography when detecting an osteomyelitis/osteonecrosis lesion as well as the lesion’s qualitative parameters, extent, and localization.

Material and methods

Identification of candidates was performed retrospectively following a search for patients with histologically or clinically confirmed osteomyelitis or osteonecrosis. They were matched with a list of patients whose disease extent and localization had been evaluated using single-photon emission computed tomography and cone beam computed tomography in the context of clinical investigations. Subsequently, two experienced examiners for each imaging technique separately performed de novo readings. Detection rate, localization, extent, and qualitative parameters of a lesion were then compared.

Results

Twenty-one patients with mandibular osteomyelitis and osteonecrotic lesions were included. Cone beam computed tomography detected more lesions than single-photon emission computed tomography (25 vs. 23; 100% vs. 92%). Cone beam computed tomography showed significantly greater depth, area, and volume, whereas length and width did not differ statistically between the two groups.

Conclusion

Both single-photon emission computed tomography and cone beam computed tomography could sensitively detect osteomyelitis/osteonecrosis lesions. Only single-photon emission computed tomography showed metabolic changes, whereas cone beam computed tomography seemed to display anatomic morphological reactions more accurately. The selection of the most adequate three-dimensional imaging and the correct interpretation of preoperative imaging remains challenging for clinicians.

Clinical relevance

In daily clinical practice, three-dimensional imaging is an important tool for evaluation of osteomyelitis/osteonecrosis lesions. In this context, clinicians should be aware of differences between single-photon emission computed tomography and cone beam computed tomography when detecting and assessing an osteomyelitis/osteonecrosis lesion, especially if a surgical bone resection is planned.

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Title: Comparative evaluation of SPECT/CT and CBCT in patients with mandibular osteomyelitis and osteonecrosis
Authors: Johann Malina-Altzinger
Bernd Klaeser
Valerie G.A. Suter
Martina Schriber
Bernd Vollnberg
Benoit Schaller
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Digital Volume Tomography
Osteonecrosis
Digital Volume Tomography
Osteomyelitis
Published in: Clinical Oral Investigations / Issue 12/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02862-8

At a glance: The STEP trials

Springer Medicine

Comparative evaluation of SPECT/CT and CBCT in patients with mandibular osteomyelitis and osteonecrosis

Abstract

Objectives

Material and methods

Results

Conclusion

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Material and methods

Results

Conclusion

Clinical relevance

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