Role of preoperative SPECT/CT standardized uptake values in medication-related osteonecrosis of the jaw: a preliminary study of SPECT/CT in relation to cone-beam CT and histopathological findings of the resected bone of mandibulectomy

Background SPECT/CT has been applied for preoperative planning of MRONJ. Furthermore, the SUV using bone SPECT/CT has enabled quantitative analysis of jaw lesions. This study aimed to evaluate the role of preoperative SPECT/CT SUVs in MRONJ, especially SPECT/CT in relation to CBCT and histopathological findings of the resected bone of mandibulectomy. The preliminary study was conducted on five MRONJ patients who underwent mandibulectomy after SPECT/CT. Results The SUVmax and SUVmean of MRONJ in all cases (19.5 ± 5.6 and 5.5 ± 0.8) were significantly higher than those of right side of the MRONJ (8.5 ± 2.0 and 2.7 ± 0.5) and left side of the MRONJ (7.2 ± 1.6 and 2.7 ± 0.4), respectively. The CBCT of all cases showed osteolytic and sclerotic internal texture and sequestrum. The histopathological characteristics of all cases showed necrotic bone and granulation tissue with the bone circumference surrounded by inflammatory cells. Conclusions The preliminary results indicated a difference between MRONJ and right and left sides of the MRONJ in SPECT/CT SUVs. The SUVs has enabled quantitative analysis for surgical planning of MRONJ.