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. 2024 Sep 1;53(6):372-381.
doi: 10.1093/dmfr/twae019.

The relationship between the uptake of alveolar bone inflammation and of cervical lymph nodes on fluoro-2-deoxy-D-glucose positron emission tomography

Masafumi Oda  1 , Hirofumi Koga  2 , Shota Kataoka  3 , Shinji Yoshii  4 , Susumu Nishina  1 , Toshihiro Ansai  3 , Yasuhiro Morimoto  1
Affiliations

The relationship between the uptake of alveolar bone inflammation and of cervical lymph nodes on fluoro-2-deoxy-D-glucose positron emission tomography

Masafumi Oda et al. Dentomaxillofac Radiol. .

Abstract

Objectives: To elucidate the relationships between the maximum standardized uptake value (SUVmax) of alveolar bone and those of lymph nodes (LNs) around the neck on 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET).

Methods: The SUVmax values of alveolar bone and of level IA, level IB, and level IIA LNs of 174 patients, including those with and without active odontogenic inflammation, on PET/CT performed for a health check were retrospectively evaluated. The upper and lower jaws were divided into four blocks (right maxilla, left maxilla, right mandible, and left mandible). The SUVmax values of each block and of the LNs were calculated. The differences in the SUVmax of each LN level between patients with and without odontogenic inflammation, and the relationship between the SUVmax values of alveolar bone and of the LNs were analysed statistically.

Results: Significant differences in SUVmax values of bilateral level IB and IIA LNs were found between patients with and without odontogenic inflammation (Mann-Whitney U test: right level IB, P = .008; left level IB, P = .006; right level IIA, P < .001; left level IIA, P = .002), but not in bilateral level IA LNs (Mann-Whitney U test: right level IA, P = .432; left level IA, P = .549). The inflammatory site with the highest SUVmax in level IB LNs was the ipsilateral mandible (multivariate analysis: right, beta = 0.398, P < .001; left, beta = 0.472, P < .001), and the highest SUVmax in level IIA LNs was the ipsilateral maxilla (multivariate analysis: right, beta = 0.223, P = .002; left, beta = 0.391, P < .001).

Conclusions: The SUVmax values of level IB and IIA LNs were associated with a tendency towards a higher SUVmax value of alveolar bone on 18F-FDG-PET.

Keywords: 18F-FDG-PET; lymph node; odontogenic inflammation.

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Conflict of interest statement

No potential conflicts of interest were disclosed.

Figures

Figure 1.
Figure 1.
Numbers of patients involved in the present study and the inclusion/exclusion criteria.
Figure 2.
Figure 2.
Representative CT and 18F-FDG-PET/CT images of a 62-year-old man with a high SUVmax of mandibular alveolar bone and ipsilateral level IB LNs are shown. (A, B) CT and 18F-FDG-PET/CT images at the mandibular level. Increased uptake (SUVmax = 5.11) in the alveolar bone of the left mandibular second molar is found (arrows). The alveolar bone around the tooth has focally disappeared and is diagnosed as periodontitis. (C, D) CT and 18F-FDG-PET/CT images at the level IB LNs. Increased uptake (SUVmax = 4.15) in the right level IB LN is found (arrows).
Figure 3.
Figure 3.
Representative CT and 18F-FDG-PET/CT images of an 88-year-old man with a low SUVmax of mandibular alveolar bone and level IB LNs are shown. (A, B) CT and 18F-FDG-PET/CT images at the mandibular level. No increased uptake in the mandibular alveolar bone (right, SUVmax = 0.55; left, SUVmax = 0.59) is found (arrows). C, D) CT and 18F-FDG-PET/CT images of the level IB LNs. No increased uptake (right, SUVmax = 0.63; left, SUVmax = 0.83) in level IB LNs is found (arrows).
Figure 4.
Figure 4.
Representative CT and 18F-FDG-PET/CT images of a 79-year-old man with a high SUVmax of maxillary alveolar bone and ipsilateral level IIA LNs are shown. (A, B) CT and 18F-FDG-PET/CT images at the maxillary level. Increased uptake (SUVmax = 5.56) in the alveolar bone of the posterior region of the maxillary first molar is found (arrows). The area is post-extraction alveolar bone of the second molar. (C, D) CT and 18F-FDG-PET/CT images of the level IIA LNs. Increased uptake (SUVmax = 3.25) in the right level IIA LNs is found (arrows).
Figure 5.
Figure 5.
Representative CT and 18F-FDG-PET/CT images of a 65-year-old man with a low SUVmax of maxillary alveolar bone and level IIA LNs are shown. (A, B) CT and 18F-FDG-PET/CT images at the maxillary level. No increased uptake in the maxillary alveolar bone (right, SUVmax = 0.79; left, SUVmax = 0.64) is found (arrows). (C, D) CT and 18F-FDG-PET/CT images of the level IIA LNs. No increased uptake (right, SUVmax = 0.91; left, SUVmax = 1.07) in level IIA LNs is found (arrows).
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