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Purpose: The purpose of this study was to assess quantitatively the mandibular bone marrow of patients with and without diabetes mellitus (DM) using the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI)., Methods: 65 DM patients (28 men, 37 women, 29-84 years of age, mean age 55.7 ± 15.7 years) and age-, sex- and periodontitis stage-matched 65 non-DM patients who had underwent MRI between April 2006 and March 2018 were included in this study. The ADC was calculated using the ADC visualization tool implemented in a dedicated off-line workstation. The regions of interest (ROI) were manually placed on the ADC map on which the mandibular bone marrow from the lower first molar to the lower second molar was observed in patients with and without DM. Statistical analysis was performed using the Mann-Whitney U test and receiver operating characteristic (ROC) curve analysis. P values < 0.05 were considered statistically significant., Results: The mean ADC values of the mandibular bone marrow of patients with and without DM were 1.18 ± 0.21 × 10 -3 mm 2 /s and 0.83 ± 0.14 × 10 -3 mm 2 /s, respectively. The ADC values of DM patients were significantly higher than those of patients without DM., Conclusion: The ADC values allowed the quantitative evaluation of the mandibular bone marrow of DM patients. DWI might serve as a new and noninvasive method to assess the presence of DM., (© 2021. The Author(s), under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd.)

Purpose: The purpose of this study was to investigate the age-related changes in apparent diffusion coefficient (ADC) values of the mandibular bone marrow using diffusion-weighted imaging (DWI)., Materials and Methods: This retrospective cohort study comprised all patients who underwent pantomography and magnetic resonance imaging (MRI) between April 2018 and November 2020 at our institution. A total of 351 participants (140 men, 211 women), aged 15-89 years (mean age 46.01 years), were included in the study. Spearman's correlation coefficients were calculated using age groups as the criterion variable and the ADC values as the explanatory variables. P < 0.05 was considered statistically significant., Results: The mean ADC value for all age groups was 0.91 ± 0.18 in men and 0.86 ± 0.16 in women (p = 0.016). There was a significant negative correlation between age and the ADC values in each sex group (p < 0.001)., Conclusion: This study demonstrates that the normal ADC values of the mandibular bone marrow show significant negative correlation with increasing age. These findings will be useful in the diagnosis of bone marrow diseases., (© 2021. The Author(s), under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd.)

Purpose: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of treatment with bisphosphonates or antiangiogenic inhibitors. MRONJ has four stages (0-3); however, stage 0 MRONJ is difficult to detect using computed tomography (CT). This study aimed to quantitatively assess the mandibular bone marrow using texture analysis to detect stage 0 MRONJ from CT images., Methods: This retrospective study included 25 patients with stage 0 MRONJ who had a history of treatment with bisphosphonates and underwent CT and magnetic resonance imaging (MRI). The mandibular bone marrow with abnormal signals (T1-weighted imaging: low, T2-weighted imaging: low or high, short-tau inversion recovery: high) on MRI, and no qualitative characteristic CT and oral findings indicative of osteonecrosis (exposed bone, sequestrum, periosteal reaction, and osteolysis) was identified as 0 MRONJ. Texture features of the bone marrow of the mandible with MRONJ and the contralateral, normal mandibular bone marrow were extracted using an open-access software, namely, LIFEx. The volumes of interest (VOIs) were manually placed on CT images by tracing the bilateral mandibular bone marrow regions, excluding the teeth, mandibular canal, and cortical bone. Thirty-seven texture features were extracted from each VOI., Results: Six gray-level run length matrix features and four gray-level zone length matrix features exhibited significant differences between mandibular bone marrow with and without MRONJ., Conclusions: CT was able to quantitatively assess texture features of normal mandibular bone marrow and that with MRONJ. Texture analysis may be useful as a new method for detecting stage 0 MRONJ using CT., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: Diabetes mellitus (DM) is associated with a broad range of complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular disease. Therefore, predicting DM from head and neck images is a challenge for clinicians. The purpose of this study was to assess the mandibular condylar bone marrow in DM patients using computed tomography (CT) texture analysis., Methods: This retrospective study included 16 DM and age and sex matched 16 control patients (11 men, 5 women; mean age, 56.8 ± 14.4 years; range 31-78 years). Patients with Type I DM, prior history of taking bisphosphonates, osteoarthritis of the temporomandibular joint, and CT images with metal artifacts were excluded from this study. Bilateral mandibular condylar bone marrow was manually contoured on axial CT images. The presence or absence of DM is the primary predictor variable. Texture features of the region of interest was the outcome variable, that were analyzed using an open-access software, MaZda Ver.3.3. For each group, 20 features out of 279 parameters were selected with Fisher, probability of error and average correlation coefficient methods in MaZda. Bivariate statistics were computed with the Mann-Whitney U test and the P value was set at .05., Results: One histogram feature, 15 Gy level co-occurrence matrix features, and four gray level run length matrix features showed differences between the DM patients and non-DM patients (P < 0.05)., Conclusions: Several texture features of the condyle demonstrated differences between the DM and non-DM patients. CT texture analysis may potentially detect DM from the condylar bone marrow., (© 2021. The Author(s), under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd.)

Diffusion-weighted imaging (DWI) is a technique reflecting motion of water proton within the tissue. Studies have investigated the apparent diffusion coefficient (ADC) of bone marrow in musculoskeletal lesions. This study assessed the correlation between the ADC of bone marrow in the mandible and the mandibular cortical width (MCW) in the healthy patients. This research was a retrospective cohort study. The patient underwent echo planar (EPI)-DWI and panoramic X-ray at the Nihon University School of Dentistry between April 2020 and October 2020. The predictor variable was mean MCW. The primary outcome variable was the mean ADC of mandibular bone marrow. The other variable was age. Data were analyzed using a Mann-Whitney U test, Spearman's correlation coefficient. Statistical significance was set at p < 0.05. We analyzed the records of 18 men (mean age, 44.94, age range 20–73 years) and 40 women (mean age, 47.98, age range 21–78 years). There was not significant difference between sex and mean ADC value, mean MCW (p = 0.853 and p= 0.43, respectively). There was a significant positive correlation between MCW and the ADC of the mandibular bone marrow (r =.493, p < 0.001). This suggests that in addition to evaluating the MCW, which is currently used for bone quality evaluation, measuring the ADC of bone marrow in the mandible could contribute toward the examination of bone quality and diseases. [ABSTRACT FROM AUTHOR]