Radiomics Analysis for Predicting Medication-Related Osteonecrosis of the Jaw Using Computed Tomography.

Authors

Abstract

To determine whether pretreatment radiomics can predict medication-related osteonecrosis of the jaw (MRONJ). Patients with mandibular MRONJ at Hiroshima University Hospital (2009-2024) who underwent MDCT before initiating bone resorption inhibitors were retrospectively identified. Records from 2009 to 2020 were also reviewed to identify patients who received these agents, had pretreatment MDCT, and remained free of MRONJ for at least 2 years. Two types of three-dimensional segmentations were performed: one including cancellous bone alone and the other including cancellous bone plus the surrounding cortical bone. Radiomic features were extracted and quantified. Least absolute shrinkage and selection operator (LASSO) regression was employed to select effective informative features. Machine learning models-Random Forest (RF), Support Vector Machine (SVM), and Multilayer Perceptron (MLP)-were trained and evaluated using sensitivity, specificity, and area under the curve (AUC). This study included 94 patients who underwent MDCT imaging at our institution before receiving bone resorption inhibitors. The cohort included 44 patients with mandibular MRONJ and 50 without. In testing for the cancellous bone-only group, RF, SVM, and MLP showed sensitivities of 0.568, 0.568, and 0.659; specificities of 0.720, 0.680, and 0.760; and AUCs of 0.741, 0.706, and 0.802, respectively. Using testing datasets from the group including both cancellous and mandibular border cortical bones, the results were: sensitivity: 0.818, 0.796, and 0.886; specificity: 0.843, 0.824, and 0.886; AUC: 0.931, 0.917, and 0.921, respectively. Radiomics analysis of pretreatment MDCT images may accurately predict MRONJ risk before exposure to bone resorption inhibitors.

Tags

Topics