SPECT/CT Correlation in the Diagnosis of Unilateral Condilar Hyperplasia.

Diego Fernando López,Valentina Ríos Borrás,Rodrigo Cardenas-Perilla,Luis Eduardo Almeida,Juan Manuel Muñoz

doi:10.3390/diagnostics11030477

Diego Fernando López, Valentina Ríos Borrás + Show 3 more

Open Access

https://doi.org/10.3390/diagnostics11030477

Copy DOI

Abstract

Objective: To evaluate the correlation between metabolic bone activity measured by single photon emission computed tomography (SPECT) and the anatomic condylar characteristics acquired by computed tomography (CT), in patients with unilateral condylar hyperplasia (UCH). Method and Materials/Patients: Observational, descriptive study in a group of 71 patients with clinical diagnosis of UCH and indication of SPECT/CT. Bone SPECT images obtained in a gamma-camera GE Infina and processed in a station Xeleris 3 with the program Volumetrix MI Evolution for bone. CT images acquired in a PET/CT Biograph mcT20 equipment (Siemens) processed in a station Osirix V 7.5.1 (Pixmeo, Bomex, Switzerland). Results: The sample included 24 men (33.8%) and 47 women (66.2%). Active state UCH was detected in 40 (56.3%) cases (over 55% uptake in the affected condyle) and 38 (53.5%) presented mandibular deviation to the right side. No significant differences related to sex, age, or mandibular deviation side were found. Mandibular deviation was the only morphologic feature related to active/inactive UCH (p = 0.003). The likelihood of active CH was significantly higher in patients with mandibular deviation higher than 6 mm compared with <6 mm (odds ratio (OR): 3.51, confidence interval (CI) 95%: 1.27–9.72). Conclusion: There is a significant correlation between the magnitude of mandibular deviation quantified on CT and metabolic findings obtained by SPECT in patients with UCH. The risk of active UCH is 3.5 times higher in patients with a mandibular deviation ≥6 mm.

Highlights

Image fusion for diagnostic purposes, as in the case of single photon emission computed tomography (SPECT)/computed tomography (CT), is known as a co-register or hybrid technique and it is used to improve the diagnostic precision and, to aid in the development of a better treatment plan positively determined by the prognosis [19]
Jacene et al [11] postulated that the hybrid SPECT/CT image compared with SPECT alone provides additional interpretative information because the CT data indicate the anatomic location of abnormal findings
The present study provides data from a sample higher than other studies published to study the correlation SPECT/CT in unilateral condylar hyperplasia (UCH) patients

Summary

Introduction

Condylar hyperplasia (CH) is a progressive and self-limiting pathology affecting the mandibular condyle growth and compromising the temporomandibular joint (TMJ) anatomy [1,2,3]. The functional, occlusal, and esthetic effects of CH in patients demand a multidisciplinary intervention to confirm a clinically suspected diagnosis and establish the therapeutic approach [4]. UCH is effectively diagnosed by measurement of bone metabolic hyperactivity in SPECT mandibular TMJ 3D images [1,6,7]. Uptake radioactive values equal or higher than 55% for the suspected condyle or a percentage side difference over 10% are commonly accepted as positive results indicating hyperactivity (active disease) of the mandibular condyle [9,10]

Objectives

Results

Discussion

Conclusion