Imaging Sci Dent.  2023 Jun;53(2):109-115. 10.5624/isd.20220202.

Texture analysis in cone-beam computed tomographic images of medication-related osteonecrosis of the jaw

• Queiroz PM
• Fardim KC
• Costa ALF
• Matheus RA
• Lopes SLPC

• KMID: 2543918
• DOI: http://doi.org/10.5624/isd.20220202

Abstract

Purpose
The aim of this study was to evaluate changes in the trabecular bone through texture analysis and compare the texture analysis characteristics of different areas in patients with medication-related osteonecrosis of the jaw (MRONJ).
Materials and Methods
Cone-beam computed tomographic images of 16 patients diagnosed with MRONJ were used. In sagittal images, 3 regions were chosen: active osteonecrosis (AO); intermediate tissue (IT), which presented a zone of apparently healthy tissue adjacent to the AO area; and healthy bone tissue (HT) (control area). Texture analysis was performed evaluating 7 parameters: secondary angular momentum, contrast, correlation, sum of squares, inverse moment of difference, sum of entropies, and entropy. Data were analyzed using the Kruskal-Wallis test with a significance level of 5%.
Results
Comparing the areas of AO, IT, and HT, significant differences (P<0.05) were observed. The IT and AO area images showed higher values for parameters such as contrast, entropy, and secondary angular momentum than the HT area, indicating greater disorder in these tissues.
Conclusion
Through texture analysis, changes in the bone pattern could be observed in areas of osteonecrosis. The texture analysis demonstrated that areas visually identified and classified as IT still had necrotic tissue, thereby increasing the accuracy of delimiting the real extension of MRONJ. (Imaging Sci Dent 2023; 53: 109-15)

Keyword

Diagnostic Imaging; Bisphosphonate-Associated Osteonecrosis of the Jaw; Cone-Beam Computed Tomography; Image Processing, Computer-Assisted