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Texture analysis using short-tau inversion recovery magnetic resonance images to differentiate squamous cell carcinoma of the gingiva from medication-related osteonecrosis of the jaw

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Abstract

Objectives

Despite the difficulty in distinguishing between squamous cell carcinoma (SCC) and medication-related osteonecrosis of the jaw (MRONJ) on the basis of medical imaging examinations, the two conditions have completely different treatment methods and prognoses. Therefore, differentiation of SCC from MRONJ on imaging examinations is very important. This study aimed to distinguish SCC from MRONJ by performing texture analysis using magnetic resonance imaging (MRI) short-tau inversion recovery images.

Methods

This retrospective case–control study included 14 patients with SCC of the lower gingiva and 35 with MRONJ of the mandible who underwent MRI and computed tomography (CT) for suspected SCC or MRONJ. SCC was identified by histopathological examination of tissues excised during surgery. The radiomics features of SCC and MRONJ were analyzed using the open-access software MaZda version 3.3 (Technical University of Lodz, Institute of Electronics, Poland). CT was used to evaluate the presence or absence of qualitative findings (sclerosis, sequestrum, osteolysis, periosteal reaction, and cellulitis) of SCC and MRONJ.

Results

Among the 19 texture features selected using MaZda feature-reduction methods, SCC of the gingiva and MRONJ of the mandible revealed differences in two histogram features, one absolute gradient feature, and 16 Gy level co-occurrence matrix features. In particular, the percentile, angular second moment, entropy, and difference entropy exhibited excellent diagnostic performance.

Conclusion

Non-contrast-enhanced MRI texture analysis revealed differences in texture parameters between mandibular SCC and mandibular MRONJ. MRI texture analysis can be a new noninvasive quantitative method for distinguishing between SCC and MRONJ.

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Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Acknowledgements

This work was supported by JSPS KAKENHI (Grant Number JP21K17101).

Funding

This work was supported by JSPS KAKENHI Grant Number JP21K17101.

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Authors and Affiliations

  1. Department of Radiology, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba, 271-8587, Japan

    Kotaro Ito, Naohisa Hirahara, Hirotaka Muraoka, Eri Sawada, Satoshi Tokunaga & Takashi Kaneda

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  1. Kotaro Ito
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  2. Naohisa Hirahara
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  3. Hirotaka Muraoka
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  4. Eri Sawada
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Correspondence to Kotaro Ito.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of the University School of Dentistry (No. EC21-003).

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The requirement to obtain written informed consent was waived for this retrospective study. All procedures followed the guidelines of the Declaration of Helsinki, Ethical Principles for Medical Research Involving Human Subjects.

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Ito, K., Hirahara, N., Muraoka, H. et al. Texture analysis using short-tau inversion recovery magnetic resonance images to differentiate squamous cell carcinoma of the gingiva from medication-related osteonecrosis of the jaw. Oral Radiol 40, 219–225 (2024). https://doi.org/10.1007/s11282-023-00725-3

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