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  • Title: Diagnostic performance of SPECT-CT imaging in unilateral condylar hyperplasia.
    Author: Karssemakers LHE, Nolte JW, Rehmann C, Raijmakers PG, Becking AG.
    Journal: Int J Oral Maxillofac Surg; 2023 Feb; 52(2):199-204. PubMed ID: 36008219.
    Abstract:
    Nuclear imaging plays an important role in the diagnostic path of patients with unilateral condylar hyperplasia (UCH). The purpose of this study was to determine the performance of single-photon emission computed tomography-computed tomography (SPECT-CT) in a large group of patients with suspected UCH. This study prospectively included 156 patients with a clinical presentation of progressive mandibular asymmetry. All patients underwent 99 mTc-HDP SPECT-CT and extensive baseline and follow-up documentation. The relative activity of the ipsilateral condyle in relation to the contralateral condyle was calculated for both the mean and maximum count, and the diagnostic accuracy of different cut-off values was determined. The area under the receiver operating characteristic curve of the SPECT-CT scan was 0.892 for the mean count and 0.873 for the maximum count. The optimal cut-off of> 8% (SPECT-CT mean count) resulted in a sensitivity of 87.0% and a specificity of 88.6%. SPECT-CT showed good diagnostic performance in UCH; however the benefit of the CT scan is questionable and the potential disadvantages have to be weighed against the benefits when compared to standard SPECT scanning. When using SPECT-CT in the diagnostic path in UCH, a mean value cut-off of>8% for the relative activity between the condyles is most accurate.
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