Maximum Standardized Uptake Value of 99mTc Hydroxymethylene Diphosphonate SPECT/CT for the Evaluation of Temporomandibular Joint Disorder

Purpose: To evaluate the diagnostic accuracy of the quantitative parameter standardized uptake value (SUV) at single photon emission computed tomography (SPECT)/computed tomography (CT) for the evaluation of temporomandibular joint (TMJ) disorder (TMD). Materials and Methods: This study was approved by the institutional review board, and the need for informed consent was waived. Forty-four TMJs in 22 patients with TMD (five men and 17 women; mean age +/- standard deviation, 30.0 years +/- 12.1) were evaluated. The patients underwent planar bone scintigraphy and SPECT/CT 3-4 hours after injection of technetium 99m hydroxymethylene diphosphonate. The planar scintigraphy parameter of relative ratio (RR) and SPECT/CT parameters mean SUV (SUVmean) and maximum SUV (SUV max) were compared for the visual assessment of TMD on planar scintigraphy images and for the presence of TMJ arthralgia. Group comparisons, receiver operating characteristic analysis, and Pearson correlation analysis were conducted. Results: SUV max gradually increased from normal (2.82 +/- 0.73) to mild or moderately abnormal (3.56 +/- 0.76, P < .05) and then to severely abnormal (4.86 +/- 1.25, P < .05). However, RR and SUVmean did not vary significantly according to visual grade (P < .05). On the other hand, SUV max was significantly greater in arthralgic TMJs (4.15 +/- 1.11) than in nonarthralgic TMJs (2.97 +/- 0.75, P < .001), as was SUV mean (1.63 +/- 0.42 vs 1.30 +/- 0.31, respectively; P = .005). However, there was no significant difference in RR (3.61 +/- 0.57 vs 3.76 +/- 0.68, P = .45). In receiver operating characteristic curve analyses for arthralgic TMJ, SUVmax had the greatest area under the curve (area of 0.815). Conclusion: SUV max derived from bone SPECT/CT may be useful for the evaluation of TMD. (C) RSNA, 2016