Quantification of Tc-99m HDP single-photon emission computed tomography/computed tomography for the evaluation of temporomandibular joint disorder

Abstract

Purpose: The purpose of this study was to evaluate the usefulness of a quantitative parameter (standardized uptake value [SUV]) from single-photon emission computed tomography/computed tomography (SPECT/CT) for the evaluation of temporomandibular joint disorder (TMD). Methods: Forty-four temporomandibular joints (TMJs) of 22 TMD patients (male:female, 5:17

age, 30.0 ± 12.1 years) were evaluated in this study. The patients underwent conventional planar bone scintigraphy and subsequently SPECT/CT 3–4 h after injection of Tc-99m hydroxymethylene diphosphonate. Planar scintigraphy parameter (relative ratio [RR]) and SPECT/CT parameters (SUVmean and SUVmax) were compared for the visual assessment of TMD on the planar scintigraphy (normal=19, mild–moderately abnormal=18, and severely abnormal=7) and the presence of TMJ arthralgia (arthralgic=18, and non-arthralgic=26). Results: SUVmax gradually increased from normal (2.82 ± 0.73) to mild–moderately abnormal (3.56 ± 0.76, p < 0.05 compared to the normal group) and then to severely abnormal group (4.86 ± 1.25, p < 0.05 compared to the mild–moderately abnormal). However, RR and SUVmean did no vary significantly according to visual grade (p > 0.05). On the other hand, SUVmax was significantly greater in arthralgic TMJs (4.15 ± 1.11) than in non-arthralgic TMJs (2.97 ± 0.75, p = 0.0001), as was SUVmean (1.63 ± 0.42 versus 1.30 ± 0.31, respectively, p = 0.0045). However, there was no significant difference in RR (3.61 ± 0.57 versus 3.76 ± 0.68, p = 0.4497). In receiver-operating characteristic curve analyses for arthralgic TMJ, SUVmax had the greatest area-under-the-curve (0.815), followed by SUVmean (0.744), which were both significantly better than that of RR (0.514) (p = 0.0093 for SUVmax, and p = 0.0350 for SUVmean). Conclusions: SUVmax derived from bone SPECT/CT may be useful for the evaluation of TMD. Quantitative bone SPECT/CT is a promising imaging tool for the evaluation of TMD.