Development of Cu application using dual-energy computed tomography for detecting medication-related osteonecrosis of the jaw

Introduction The present study developed an application using dual-energy computed tomography (DECT) focused on Cu for detecting medication-related osteonecrosis of the jaw (MRONJ). Materials and methods First, we performed two types of phantom studies using a Cu wire syringe and pig mandible with C...

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Bibliographic Details
Published in:Journal of bone and mineral metabolism 2023-11, Vol.41 (6), p.865-876
Main Authors: Shigenaga, Kazuki, Arimoto, Satomi, Kubo, Masahiro, Sato, Takumi, Hiraoka, Yujiro, Takeda, Daisuke, Hasegawa, Takumi, Kagawa, Kiyosumi, Akashi, Masaya
Format: Article
Language:English
Subjects:
Computed tomography
Jaw
Medicine
Medicine & Public Health
Metabolic Diseases
Necrosis
Original Article
Orthopedics
Osteonecrosis
Spectroscopy
Tomography
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Summary:Introduction The present study developed an application using dual-energy computed tomography (DECT) focused on Cu for detecting medication-related osteonecrosis of the jaw (MRONJ). Materials and methods First, we performed two types of phantom studies using a Cu wire syringe and pig mandible with Cu wire to detect Cu on DECT. Second, DECT examinations of 44 patients with MRONJ were performed to compare lesion and normal bone sites using single-energy CT, DECT-virtual non-calcium (VNCa), and DECT-Cu applications. Quantitative analyses of VNCa CT and CT values were performed, and a cut-off value was calculated using receiver operating characteristic analysis. Third, we compared the Cu content in the MRONJ and normal bone groups using inductively coupled plasma atomic emission spectroscopy (ICP-AES). Results The material-specific differences in attenuation between the two different energies enabled the accurate separation of Cu from Ca in phantom studies. The sensitivity and specificity for single-energy CT, DECT-VNCa, and DECT-Cu applications were 97.7% and 2.3%, 86.4% and 81.8%, and 88.6% and 97.7%, respectively. Thus, VNCa CT values obtained on DECT-Cu application images showed the highest area under the curve value and maximal diagnostic efficacy in differentiating lesion sites from normal bone sites. On ICP-AES analyses, the Cu content was significantly higher in the MRONJ group than in the normal bone group. Conclusion DECT-Cu application demonstrated better diagnostic performance in detecting MRONJ compared with single-energy CT or DECT-VNCa.
ISSN:0914-8779
1435-5604
DOI:10.1007/s00774-023-01467-2