@article {Guggenberger1242, author = {R. Guggenberger and D.R. Fischer and P. Metzler and G. Andreisek and D. Nanz and C. Jacobsen and D.T. Schmid}, title = {Bisphosphonate-Induced Osteonecrosis of the Jaw: Comparison of Disease Extent on Contrast-Enhanced MR Imaging, [18F] Fluoride PET/CT, and Conebeam CT imaging}, volume = {34}, number = {6}, pages = {1242--1247}, year = {2013}, doi = {10.3174/ajnr.A3355}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: Imaging of bisphosphonate-induced osteonecrosis of the jaw is essential for surgical planning. We compared the extent of BONJ on contrast-enhanced MR imaging, [18F] fluoride PET/CT, and panoramic views derived from standard conebeam CT with clinical pre- and intraoperative examinations. MATERIALS AND METHODS: Between February 2011 and January 2012, ten subjects with written informed consent (9 women; mean, 69.6 years; range, 53{\textendash}88 years) were included in this prospective ethics-board-approved study. Patients underwent CEMR imaging, [18F] fluoride PET/CT, and CBCT and were clinically examined pre- and intraoperatively. Surgery was performed, and BONJ was histologically confirmed in 9 patients. Location and extent of BONJ on different modalities/examinations were graphically compared (0 = no pathologic finding, 1 = smallest, 5 = largest extent of BONJ). Rank tests were used to assess overall and paired differences of ratings in 9 patients. A P value \<.05 was considered statistically significant. RESULTS: Significant differences in BONJ extent among different modalities and examinations were found (P \< .001). The highest median rank was seen in PET/CT (4 {\textpm} 1.12) and CEMR imaging (4 {\textpm} 1.01), followed by intraoperative examinations (3 {\textpm} 0.71), CBCT (2 {\textpm} 0.33), and preoperative examinations (1 {\textpm} 0). No significant differences were found between PET/CT and CEMR imaging (P = .23), except when comparing PET/CT to either CBCT, pre- and intraoperative examinations (all P \< .05). Preoperative examinations showed significantly less extensive disease than all other modalities/examinations (all P \< .05). CONCLUSIONS: [18F] fluoride PET/CT and CEMR imaging revealed more extensive involvement of BONJ compared with panoramic views from CBCT and clinical examinations. BONJbisphosphonate-induced osteonecrosis of the jawCBCTconebeam CTCEMRcontrast-enhanced MRMDCTmultidetector CTSTIRshort τ inversion recovery}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/34/6/1242}, eprint = {https://www.ajnr.org/content/34/6/1242.full.pdf}, journal = {American Journal of Neuroradiology} }