Mandibular osteoradionecrosis: a comparison of computed tomography with panoramic radiography

Osteoradionecrosis after Radiation Therapy for Head and Neck Cancer: Differentiation from Recurrent Disease with CT and PET/CT Imaging

“…This finding may reflect the tendency of squamous cell carcinoma to induce bony destruction rather than sclerosis in contradistinction to the often chronic nature of ORN that may be associated with bony sclerosis. 13,23 Thus, while most patients with ORN may not have bony sclerosis, the presence of this finding on imaging should prompt a relatively confident diagnosis of ORN rather than tumor recurrence. Similarly, intraosseous gas, which has been suggested to be pathognomonic of superimposed osteomyelitis, 24 was not seen in any of our patients with tumor recurrence.…”

Osteoradionecrosis of the mandible: through a radiologist's eyes

“…PR depicts osseous changes of ORN, however, with lesser sensitivity than cross-sectional imaging techniques. 20 Early osseous changes are not easily detected, as it requires at least 30e50% reduction in the bone mineral density to be detected on conventional radiographs. 21 PR is also not able to depict accurately the soft-tissue changes associated with ORN.…”

“…Hence, PR is recommended for follow-up and monitoring patients who are at risk of ORN; but is not very accurate for evaluation of extent. 20 Radiation damage to the mandible can lead to loss of bone mass with resorption of the osseous trabeculae. On OPG, it is seen initially as rarefaction of the affected bone, or later, as lytic areas within the mandible (Fig 2).…”

“…7,20,22,23 Store and Larheim 20 compared the efficacy of CT and PR in the diagnosis and pre-surgical evaluation of mandibular ORN, by evaluating 31 cases. They concluded that CT is superior to PR in visualizing the radiological features of ORN and the anterioreposterior extent of the lesion.…”

Bisphosphonat-assoziierte Osteonekrosen des Kieferknochens

“…Es ist allerdings nicht geeignet, um frühe nekrotische Läsionen zu diagnostizieren [69]. Die Computertomographie bietet den Vorteil der dreidimensionalen Darstellung, allerdings ist auch bei dieser Methode erst eine fortgeschrittene ONJ zu erkennen.…”