Determination of Mandibular Condylar Uptake in Asymptomatic Populatio

Raana Fatima; Fida  Hussain; Zaigham Salim  Dar; Muhammad Inamullah  Nouman; Rebecca  Sharoon; Mehdi  Raza

doi:10.51253/pafmj.v76iSUPPL-3.13544

Authors

Raana Fatima Department of Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Fida Hussain Department of Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Zaigham Salim Dar Department of Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Muhammad Inamullah Nouman Department of Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Rebecca Sharoon Department of Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Mehdi Raza Department of Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-3.13544

Keywords:

Computed Tomography, Facial Asymmetry, Mandibular Condylar Hyperplasia

Abstract

Objective: To determine mandibular condylar uptake values in normal population through quantitative analysis employing Tc-99m MDP SPECT/CT.

Study Design: Cross-sectional study.

Place and Duration of study: Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from Jul 22 to Jul 23.

Methodology: A total of 129 individuals, both genders aged 10 to 40 years, with no known skull pathology, were included in the study. Quantitative analysis of Tc-99m MDP SPECT/CT bone scan of asymptomatic population was used to calculate mandibular condyle to clivus ratio. A percentage uptake difference less than or equal to 10 % between both mandibular condyles was considered acceptable.

Result: The study cohort comprised 129 subjects (n=129), with 72(55.8%) males and 57(44.1%) females. Age ranged from 12 to 40 years (Mean±SD: 25.70±8.49). The mean mandibular condyle-to-clivus ratio on the right side was 0.97±0.12 and on the left was 0.98±0.13, which showed low variability (CV ~ 12 – 13%). However, the mean percentage difference in condylar uptake on both sides was 4.13±2.64 %, which showed very high variability (CV=63.92%). Gender-based comparison showed a significantly higher right condyle to clivus ratio in females (1.00±0.10) compared to males (0.94±0.12), with a p-value of 0.005 and a moderate effect size (Cohen’s d = -0.33).

Conclusion: Determination of normal mandibular condylar uptake values in our population will contribute to enhanced diagnostic accuracy in maxillofacial applications of nuclear medicine, like condylar hyperplasia or Temporomandibular joint (TMJ) abnormalities.

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References

1. Vika M, Jörn S, Maike de W, Karl H. Bohuslavizki. Bone scintigraphy in clinical routine Radiol Oncol 2001; 35(1): 21-30

2 Fernandes A, Faria M, Oliveira A, Coelho PB, Pereira J. Assessment of relative uptake by mandibular condyles in a “normal” population. Br J Oral Maxillofac Surg 2019; 57(3): 251-254.

https://doi.org/10.1016/j.bjoms.2018.12.016

3. AlSharif AA, Tarawneh ES, AlKawaleet YI, Abukaraky AE, AlAhmad HT, Malkawi ZA, et al. Standardization of quantitative single-photon emission computed tomography in control individuals and in patients with condylar hyperplasia. Nucl Med Commun 2014; 35(12): 1268-1276.

https://doi:10.1097/MNM.0000000000000074

4. Rodriguez I, Mut F. Quantitative bone SPECT analysis of mandibular condyles in an asymptomatic population: an approach to normal reference values. Int J Oral Maxillofac Surg 2021; 50(6): 733-739.

https://doi.org/10.1016/j.ijom.2020.11.011

5. Riechmann M, Gellrich N-C, Kress B, Schmidt C, Schröder C, Neff A. Clinical Practice Guideline: Condylar Hyperplasia of the Mandible—Diagnosis and Treatment. Dtsch Ärztebl Int 2024; 121: 816–823.

https://doi:10.3238/arztebl.m2024.0210

6. Anzola LK, Venegas N, Jaramillo MC, Moreno S, Hinojosa M, Amador E, et al. Diagnostic Efficacy of Bone SPECT Techniques in Differentiating Unilateral and Bilateral Condylar Hyperplasia. Diagnostics 2024; 14(22): 2548.

https://https://doi:10.3390/diagnostics14222548

7. Wen B, Shen Y, Wang C-Y. Clinical Value of 99Tcm‐MDP SPECT Bone Scintigraphy in the Diagnosis of Unilateral Condylar Hyperplasia. Sci. World J 2014; 2014(1): 256256.

https://doi.org/10.1155/2014/256256

8. Olate S, Ravelo V, Alister JP, Netto HD, Haidar ZS, Sacco R. Early Treatment of Unilateral Condylar Hyperplasia in Adolescents: Preliminary Results. J. Clin. Med 2023; 12(10): 3408. https://doi.org/10.3390/jcm12103408

9. Haider SMM, Younis MN, Hanan SD, Bader R. Comparison of bone scan and SPECT/CT in detection of condylar hyperplasia. Pak. J. Med. Health Sci 2022; 16(1): 189-191.

https://doi.org/10.53350/pjmhs22161189

10. Ouyang N, Zhang C, Xu F, Chen T, Shen G, Si J, et al. Evaluation of optimal single-photon emission computed tomography reference value and three-dimensional mandibular growth pattern in 54 Chinese unilateral condylar hyperplasia patients. Head Face Med 2023; 19(1): 18.

https://doi.org/10.1186/s13005-023-00365-2

11. Guennouni A, Aallah WH, Abourak C, Oukassem S, El Kettani NE-C, Fikri M, et al. A facial asymmetry revealed: Active mandibular condylar hyperplasia. Radiol. Case Rep 2025; 20(5): 2463-2467. https://doi.org/10.1016/j.radcr.2025.01.079

12. López DF, Castro MA, Muñoz JM, Cárdenas‐Perilla R. Reference values of mandibular condyles metabolic activity: A study using 99mTc‐MDP single‐photon emission computed tomography. Orthod Craniofac Res 2021; 24(3): 328-334.

https://doi. org/:10.1111/ocr.12434

13 López DF, Orozco MF, Ochoa Gómez S, Herrera Guardiola S, Almeida LE. Bilateral Condylar Hyperplasia: Importance of Its Diagnosis in the Treatment and Long-Term Stability of Skeletal Class III Correction. Diagnostics 2025; 15(7): 809.

https://doi.org/10.3390/diagnostics15070809

14. Niño-Sandoval TC, Maia FPA, Vasconcelos BCE. Efficacy of proportional versus high condylectomy in active condylar hyperplasia - A systematic review. J Craniomaxillofac Surg 2019; 47(8): 1222-1232. https://doi:10.1016/j.jcms.2019.03.024

15. De Schepper S, Gnanasegaran G, De Vos W, Van de Casteele E, Dickson JC, Van den Wyngaert T. From SPECT/CT towards absolute quantification?-the case of unilateral condylar hyperplasia of the mandible. EJNMMI physics 2024; 11(1): 74.

https://doi.org/10.1186/s40658-024-00676-6

16 Karssemakers L, Besseling L, Schoonmade L, Su N, Nolte J, Raijmakers P, et al. Diagnostic accuracy of bone SPECT and SPECT/CT imaging in the diagnosis of unilateral condylar hyperplasia: a systematic review and meta-analysis. J Craniomaxillofac Surg 2024; 52: 447-453.

https://doi org/10.1016/j.jcms.2024.01.013

17. Hamed MAG, AlAzzazy MZ, Basha MAA. The validity of SPECT/CT in diagnosis of condylar hyperplasia. Egypt. J Radiol Nucl Med 2017; 48(2): 451-459.

https://doi.org/10.1016/j.ejrnm.2017.03.019

19. López DF, Ríos Borrás V, Muñoz JM, Cardenas-Perilla R, Almeida LE. SPECT/CT Correlation in the diagnosis of unilateral condylar hyperplasia. Diagnostics 2021; 11(3): 477.

https://doi.org/10.3390/diagnostics11030477

20. Agarwal KK, Mukherjee A, Tripathi M, Bal C. Incremental value of single-photon emission computed tomography/computed tomography in the diagnosis of active condylar hyperplasia. Nucl Med Commun 2017; 38(1): 29-34.

https://doi:10.1097/MNM.0000000000000607

21. Liu P, Shi J. Growth trends analysis of unilateral condylar hyperplasia followed up with planar scintigraphy: Retrospective overview of 249 cases. Medicine 2021; 100(51): e28226.

https://doi.org/10.1097/MD.0000000000028226

22. Alsayegh HA, Alsubaie ZA, Alwayil AR, Alqadhi MA, Alawadh AM, Alsubaie Z, et al. Unilateral Condylar Hyperplasia With Active Bony Overgrowth: A Case Report. Cureus 2021; 13:(10): e19059. https://doi.org/:10.7759/cureus.1905977