Use of FDG PET to Evaluate Hyperbaric Oxygen Therapy for Bisphosphonate-Related Osteonecrosis of the Jaw

摘要

An 80-year-old man presented with painful swelling in the mandibular region and fistula with pus discharge that developed after tooth extractions. He had taken oral alendronate sodium hydrate and prednisolone for osteoporosis for five years. The lesion was diagnosed as bisphosphonate-related osteonecrosis of the jaw. FDG-PET revealed a high accumulation of FDG in the right mandibular region. The patient underwent hyperbaric oxygen therapy twenty times. FDG-PET SUVmax drastically decreased from 5.6 to 1.8 after hyper baric oxygen therapy, paralleling the change in clinical symptoms, while other modalities did not show remarkable changes. This is the first study demonstrating the utility of FDG-PET in monitoring hyper baric oxygen therapy for bisphosphonate-related osteonecrosis of the jaw.