Popis: |
Background. Nuclear Medicine imaging techniques, i.e., planar bone scan (Tc99 m scintigraphy) and PET (Positron Emission Tomography) with several tracers, have been suggested as useful aids to diagnosis of Osteonecrosis of Jaw (ONJ), that is mostly based on clinical observation (signs and symptoms, with/without bone exposure) and Computed Tomography (CT) scan. Potential advantages of Nuclear Medicine techniques include very early detection of ONJ (due to precocious uptakes), especially in ONJ cases without frank bone exposure. Prostate cancer patients treated with bisphosphonates or denosumab are at risk of ONJ. They undergo bone scan and/or 18F-Choline PET-CT aimed to evaluate response to treatment but attention is generally pointed to extracranial uptakes. Literature data show ability of bone scan to detect maxillary and mandible areas at risk of clinically relevant ONJ, but data are lacking about 18F-Choline PET-CT. Material and Methods. We retrospectively reviewed 18F-Choline PET-CT scans of prostate cancer patients with diagnosis of ascertained ONJ (at CT scan) to search for uptakes in maxillary bones and mandible at time of ONJ diagnosis, or before, or after. Results. Out of 5 prostate cancer patients undergoing 18F-Choline PET-CT scans before or after the ONJ diagnosis time, 4 had clear jaw uptakes at ONJ site next to ONJ diagnosis time or before; one had no uptake (4 years after ONj diagnosis). Conclusions. Our limited experience indicates that 18F-Choline PET-CT scan uptakes, as well as planar bone scan uptakes, are of potential help to early detect ONJ areas, sometimes still in absence of signs and symptoms. Further studies with larger numbers of prostate cancer patients with and without ONJ disease are warranted and should be planned as multicentre trials. The 18F-Choline PET-CT scan uptakes at maxillary bone and mandible should be reported and underlined by Nuclear Medicine specialists, as well as bone scan uptakes, as an aid to oncologists, oral care specialists and patients. |