Imaging Sci Dent.  2020 Mar;50(1):31-36. 10.5624/isd.2020.50.1.31.

Impact of radiotherapy on mandibular bone: A retrospective study of digital panoramic radiographs

• Palma LF
• Tateno RY
• Remondes C
• Marcucci M
• Cortes AR

• KMID: 2471843
• DOI: http://doi.org/10.5624/isd.2020.50.1.31

Abstract

PURPOSE
The purpose of this study was to investigate the impact of radiotherapy on mandibular bone tissue in head and neck cancer patients through an analysis of pixel intensity and fractal dimension values on digital panoramic radiographs.
MATERIALS AND METHODS
Thirty patients with radiographic records from before and after 3-dimensional (3D) conformational radiotherapy were selected. A single examiner carried out digital analyses of pixel intensity values and fractal dimensions, with the areas of interest unilaterally located in the right angle medullary region of the mandible below the mandibular canal and posterior to the molar region.
RESULTS
Statistically significant decreases were observed in the mean pixel intensity (P=0.0368) and fractal dimension (P=0.0495) values after radiotherapy.
CONCLUSION
The results suggest that 3D conformational radiotherapy for head and neck cancer negatively affected the trabecular microarchitecture and mandibular bone mass.

Keyword

Mandible; Panoramic Radiography; Radiotherapy

MeSH Terms

Bone and Bones
Fractals
Head and Neck Neoplasms
Humans
Mandible
Molar
Radiography, Panoramic
Radiotherapy*
Retrospective Studies*

Figure

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  Fig. 1 Region of interest selection.

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  Fig. 2 Fractal dimension analysis process. A. Region of interest. B. Result of blurring of (A). C. Result of subtracting (B) from (A). D. Result of adding 128 to each pixel position of (C). E. Result of conversion of (D) into a binary image. F. Result of erosion and dilation of (E). G. Result of inversion of (F). H. Result of skeletonizing of (G). I. Result of superpositioning (H) over (A).

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