{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:28:29Z","timestamp":1760711309111,"version":"build-2065373602"},"reference-count":49,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["EXC2180-390900677"],"award-info":[{"award-number":["EXC2180-390900677"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of T\u00fcbingen","award":["EXC2180-390900677"],"award-info":[{"award-number":["EXC2180-390900677"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: The purpose of this study was to investigate the imaging characteristics of medication-related osteonecrosis of the jaw (MRONJ) using [18F]fluoride positron emission tomography\/computed tomography (PET\/CT) and [18F]fluorodeoxyglucose (FDG) PET\/magnetic resonance imaging (MRI) for preoperative assessment and to correlate them with microarchitectural and histomorphometric data with respect to clinical findings. Methods: Twelve patients (five female; mean age 75 \u00b1 7.6 yr) with symptomatic MRONJ underwent both scans on the same day, and imaging findings were used to plan surgical interventions for seven patients. Bone tracer uptake was classified as high, medium, or low, and surgical samples were evaluated using Micro-CT and histomorphometric analysis. Results: CT showed medullary sclerosis in all patients, and MRI revealed gadolinium enhancement in four patients. PET imaging revealed remarkably elevated [18F]fluoride uptake and moderately increased [18F]FDG uptake in MRONJ compared to healthy jawbones, with both differences being statistically significant. [18F]fluoride uptake was associated with necrosis, bacteria, and inflammatory tissue. Micro-CT data did not show significant differences, but histomorphometric analysis revealed higher osteocyte and lacunae densities in the high [18F]fluoride uptake group, and more necrotic bone in the medium [18F]fluoride uptake group. Bacteria were observed in all areas. Conclusions: In summary, [18F]fluoride PET accurately identified MRONJ extent, revealing functional changes in jawbone remodeling not visible on CT. [18F]FDG PET showed differences in bone and soft tissue, though less pronounced. This method aids in evaluating disease activity and guiding treatment planning, requiring further research for optimal surgical approaches based on tracer uptake.<\/jats:p>","DOI":"10.3390\/diagnostics14040428","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T05:55:59Z","timestamp":1707976559000},"page":"428","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Preoperative Assessment of Medication-Related Osteonecrosis of the Jaw Using [18F]fluoride Positron Emission Tomography (PET)\/CT and [18F]fluorodeoxyglucose PET\/MRI in Correlation with Histomorphometry and Micro-CT\u2014A Prospective Comparative Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2911-3514","authenticated-orcid":false,"given":"Christian Philipp","family":"Reinert","sequence":"first","affiliation":[{"name":"Department of Radiology, Diagnostic and Interventional Radiology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Pfannenberg","sequence":"additional","affiliation":[{"name":"Department of Radiology, Diagnostic and Interventional Radiology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"G\u00fcckel","sequence":"additional","affiliation":[{"name":"Department of Radiology, Diagnostic and Interventional Radiology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6840-5571","authenticated-orcid":false,"given":"Helmut","family":"Dittmann","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nuclear Medicine and Clinical Molecular Imaging, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7519-0417","authenticated-orcid":false,"given":"Christian","family":"la Foug\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nuclear Medicine and Clinical Molecular Imaging, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"},{"name":"Cluster of Excellence iFIT (EXC 2180) \u201cImage Guided and Functionally Instructed Tumor, Therapies\u201d, University of T\u00fcbingen, 72076 T\u00fcbingen, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2668-7325","authenticated-orcid":false,"given":"Konstantin","family":"Nikolaou","sequence":"additional","affiliation":[{"name":"Department of Radiology, Diagnostic and Interventional Radiology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"},{"name":"Cluster of Excellence iFIT (EXC 2180) \u201cImage Guided and Functionally Instructed Tumor, Therapies\u201d, University of T\u00fcbingen, 72076 T\u00fcbingen, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siegmar","family":"Reinert","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rouven","family":"Sch\u00f6nhof","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0017-4575","authenticated-orcid":false,"given":"Sebastian","family":"Hoefert","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jcms.2020.02.017","article-title":"Medication-related osteonecrosis of the jaw (MRONJ) stage III: Conservative and conservative surgical approaches versus an aggressive surgical intervention: A systematic review","volume":"48","author":"Vanpoecke","year":"2020","journal-title":"J. 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