Medical Radiology and Radiation Safety. 2018. Vol. 63. No. 5. P. 26 –32

NUCLEAR MEDICINE

DOI: 10.12737/article_5bc8968bb9d9a3.36167944

SPECT/CT in the Assessment of the Jaw Autograft Viability

A.D. Ryzhkov¹, L.P. Yakovleva¹, A.S. Krylov¹, S.V. Shiryaev¹, M.A. Kropotov², V.A. Sobolevsky¹, Yu.Yu. Dikov¹, R.B. Azimova¹, V.Yu. Ivashkov¹

1. N.N. Blokhin Medical Research Center of Oncology. Moscow, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. A.S. Loginov Moscow Clinical Scientific Center. Moscow, Russia

A.D. Ryzhkov – Leading Researcher, Dr. Sc. Med.; L.P. Yakovleva – Head of the Dep., PhD Med, Member of RUSSCO, Member of the Russian Association of Endocrine Surgeons, Member of the Society of Specialists in the Treatment of Head and Neck Tumors; A.S. Krylov – Radiologist, PhD Med., Member of the European Association of Nuclear Medicine and Molecular Imaging (EANMMI); S.V. Shiryaev – Head of Lab., Dr. Sc. Med., President of the OSMI, Member of EANMMI, Member of ACNMMI, Member of SNMMI; M.A. Kropotov – Leading Researcher, Dr. Sc. Med., Head of Dep., Member of RUSSCO, Member of the Russian Association of Endocrine Surgeons, Member of the Society of Specialists in the Treatment of Head and Neck Tumors; V.A. Sobolevsky – Head of Dep., Dr. Sc. Med.; Yu.Yu. Dikov – Research Worker, PhD Med.; R.B. Azimova – Research Worker, PhD Med.; V.Yu. Ivashkov – Research Worker

Abstract

Purpose: To evaluate the effectiveness of SPECT/CT for the assessment of graft viability following revascularized bone grafts in patients with mandibular (18) and maxilla (1) reconstruction.

Material and methods: We investigated 19 patients with revascularized grafts from the fibula (16 patients), iliac crest (2 patients) and shoulder blade graft (1). For the follow up of all these patients, 99mTc-MDP bone scintigraphy and SPECT/CT was performed between 4–5 days postoperatively. The evaluation of the grafts was based on a comparison of tracer uptake between graft and the cranium.

Results: 17 of 19 grafts had an uncomplicated clinical course. Complications in the graft occurred in two patients. In the analysis of planar scintigrams with uncomplicated healing were showed correct assessment in 10 of 17 patients and in 1of 2 patients with signs of necrosis of graft fragments. SPECT/CT was performed in addition to planar imaging.

The increased uptake grafts were showed with SPECT/CT in all patients with uncomplicated clinical course. In the failed 2 grafts, decreased uptake was observed in both patients. In the analysis of SPECT/CT images the correct results were showed in all clinical cases.

Conclusion: SPECT/CT performed within 6 days after the mandibular reconstruction is a useful tool to monitor the viability and early complications of revascularized mandibular and maxilla bone grafts. SPECT/CT is also recommended to interpretation of the bone scans and to precise assessment of graft viability.

Key words: maxilla and mandible reconstruction, autograft viability, bone scintigraphy, SPECT/CT

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For citation: Ryzhkov AD, Yakovleva LP, Krylov AS, Shiryaev SV, Kropotov MA, Sobolevsky VA, Dikov YuYu, Azimova RB, Ivashkov VYu. SPECT/CT in the Assessment of the Jaw Autograft Viability. Medical Radiology and Radiation Safety. 2018;63(5):26-32. Russian.

DOI: 10.12737/article_5bc8968bb9d9a3.36167944

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