Role of magnetic resonance imaging in diagnosis of bisphosphonate-related osteonecrosis of the jaw
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To clarify the magnetic resonance (MR) imaging features of bisphosphonate-related osteonecrosis of the jaw (BRONJ), particularly those in the early stage, through a literature review and case analysis.
Literature on MR imaging of BRONJ was collected, and the MR imaging features were summarized. On MR images of patients with BRONJ, the signal intensity of the bone marrow was evaluated quantitatively by means of the contrast-to-noise ratio (CNR). The relationships of the imaging features with the presence of exposed bone, types and administration routes of bisphosphonates (BP), and duration of symptoms were investigated.
Fifteen articles were identified. In the early stages, the region of osteonecrosis displayed decreased signal intensity on T1-weighted images and normal signal intensity on T2-weighted images. In the late stages, the signal intensity of the bone marrow on T2-weighted images was variable: the exposed diseased bone displayed decreased signal intensity, and the unexposed diseased bone displayed increased signal intensity. These changes were also seen in BRONJ cases. There was a significant difference in the CNR between the exposed and unexposed diseased bones on STIR images. There were no significant differences in the CNR among the three groups by types and administration routes of BP, both on T1-weighted and STIR images. Changes in the signal intensity of bone marrow were seen at the early duration of symptoms. In the early stage, the CNR on T1-weighted images had a significant correlation with duration of symptoms.
MR imaging may provide visualization of useful features in the early stage of BRONJ.
- Carter G, Goss AN, Doecke C. Bisphosphonates and avascular necrosis of the jaw: a possible association. Med J Aust. 2005;182:413–5.
- Woo SB, Hellstein JW, Kalmar JR. Narrative [corrected] review: bisphosphonates and osteonecrosis of the jaws. Ann Intern Med. 2006;144:753–61. CrossRef
- Coleman RE. Bisphosphonates: clinical experience. Oncologist. 2004;9:14–27. CrossRef
- Wellington K, Goa KL. Zoledronic acid: a review of its use in the management of bone metastases and hypercalcaemia of malignancy. Drugs. 2003;63:417–37. CrossRef
- Gonzalez-Moles MA, Bagan-Sebastian JV. Alendronate-related oral mucosa ulcerations. J Oral Pathol Med. 2000;29:514–8. CrossRef
- Stockmann P, Hinkmann FM, Lell MM, Fenner M, Vairaktaris E, Neukam FW, et al. Panoramic radiograph, computed tomography or magnetic resonance imaging. Which imaging technique should be preferred in bisphosphonate-associated osteonecrosis of the jaw? A prospective clinical study. Clin Oral Investig. 2010;14:311–7. CrossRef
- Urade M, Tanaka N, Furusawa K, Shimada J, Shibata T, Kirita T, et al. Nationwide survey for bisphosphonate-related osteonecrosis of the jaws in Japan. J Oral Maxillofac Surg. 2011;69:e364–71. CrossRef
- Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003;61:1115–7. CrossRef
- Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg. 2004;62:527–34. CrossRef
- Morag Y, Morag-Hezroni M, Jamadar DA, Ward BB, Jacobson JA, Zwetchkenbaum SR, et al. Bisphosphonate-related osteonecrosis of the jaw: a pictorial review. Radiographics. 2009;29:1971–84. CrossRef
- Bedogni A, Blandamura S, Lokmic Z, Palumbo C, Ragazzo M, Ferrari F, et al. Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:358–64. CrossRef
- Wutzl A, Eisenmenger G, Hoffmann M, Czerny C, Moser D, Pietschmann P, et al. Osteonecrosis of the jaws and bisphosphonate treatment in cancer patients. Wien Klin Wochenschr. 2006;118:473–8. CrossRef
- Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2007;22:1479–91. CrossRef
- Gill SB, Valencia MP, Sabino ML, Heideman GM, Michel MA. Bisphosphonate-related osteonecrosis of the mandible and maxilla: clinical and imaging features. J Comput Assist Tomogr. 2009;33:449–54. CrossRef
- Bantis A, Zissimopoulos A, Sountoulides P, Kalaitzis C, Giannakopoulos S, Deftereos S, et al. Bisphosphonate-induced osteonecrosis of the jaw in patients with bone metastatic, hormone-sensitive prostate cancer. Risk factors and prevention strategies. Tumori. 2011;97:479–83.
- Bisdas S, Chambron Pinho N, Smolarz A, Sader R, Vogl TJ, Mack MJ. Bisphosphonate-induced osteonecrosis of the jaws: CT and MRI spectrum of findings in 32 patients. Clin Radiol. 2008;63:71–7. CrossRef
- Arce K, Assael LA, Weissman JL, Markiewicz MR. Imaging findings in bisphosphonate-related osteonecrosis of jaws. J Oral Maxillofac Surg. 2009;67:75–84. CrossRef
- Dore F, Filippi L, Biasotto M, Chiandussi S, Cavalli F, Di Lenarda R. Bone scintigraphy and SPECT/CT of bisphosphonate-induced osteonecrosis of the jaw. J Nucl Med. 2009;50:30–5. CrossRef
- Chiandussi S, Biasotto M, Dore F, Cavalli F, Cova MA, Di Lenarda R. Clinical and diagnostic imaging of bisphosphonate-associated osteonecrosis of the jaws. Dentomaxillofac Radiol. 2006;35:236–43. CrossRef
- Krishnan A, Arslanoglu A, Yildirm N, Silbergleit R, Aygun N. Imaging findings of bisphosphonate-related osteonecrosis of the jaw with emphasis on early magnetic resonance imaging findings. J Comput Assist Tomogr. 2009;33:298–304. CrossRef
- Dannemann C, Gratz KW, Riener MO, Zwahlen RA. Jaw osteonecrosis related to bisphosphonate therapy: a severe secondary disorder. Bone. 2007;40:828–34. CrossRef
- Garcia-Ferrer L, Bagan JV, Martinez-Sanjuan V, Hernandez-Bazan S, Garcia R, Jimenez-Soriano Y, et al. MRI of mandibular osteonecrosis secondary to bisphosphonates. AJR Am J Roentgenol. 2008;190:949–55. CrossRef
- Wass JA. Biphosphonate-induced osteonecrosis of the jaws: CT and MRI spectrum of findings in 32 patients. Clin Radiol. 2008;63:78–9. CrossRef
- Ariji Y, Izumi M, Gotoh M, Naitoh M, Katoh M, Kuroiwa Y, et al. MRI features of mandibular osteomyelitis: practical criteria based on an association with conventional radiography features and clinical classification. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:503–11. CrossRef
- Kumar SK, Meru M, Sedghizadeh PP. Osteonecrosis of the jaws secondary to bisphosphonate therapy: a case series. J Contemp Dent Pract. 2008;9:63–9.
- Durie BG, Katz M, Crowley J. Osteonecrosis of the jaw and bisphosphonates. N Engl J Med. 2005;353:99–102. CrossRef
- Schubert M, Klatte I, Linek W, Müller B, Döring K, Eckelt U, et al. The Saxon bisphosphonate register—therapy and prevention of bisphosphonate-related osteonecrosis of the jaws. Oral Oncol. 2012;48:349–54. CrossRef
- Filleul O, Crompot E, Saussez S. Bisphosphonate-induced osteonecrosis of the jaw: a review of 2,400 patient cases. J Cancer Res Clin Oncol. 2010;136:1117–24. CrossRef
- Bamias A, Kastritis E, Bamia C, Moulopoulos LA, Melakopoulos I, Bozas G, et al. Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol. 2005;23(34):8580–7. CrossRef
- Advisory Task Force on Bisphosphonate-Related Osteonecrosis of the Jaws, American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg. 2007;65:369–76. CrossRef
- Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S, et al. Bisphosphonate-related osteonecrosis of the jaw: position paper from the Allied Task Force Committee of Japanese Society for Bone and Mineral Research, Japan Osteoporosis Society, Japanese Society of Periodontology, Japanese Society for Oral and Maxillofacial Radiology, and Japanese Society of Oral and Maxillofacial Surgeons. J Bone Miner Metab. 2010;28:365–83. CrossRef
- Role of magnetic resonance imaging in diagnosis of bisphosphonate-related osteonecrosis of the jaw
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