Quantitative CT texture analysis of the mandibular condyle in medication-related osteonecrosis of the jaw

Purpose In this study, we quantitatively assessed the involvement of the mandibular condyle in patients with medication-related osteonecrosis of the jawbone (MRONJ) based on computed tomography (CT) texture analysis. Material and methods We analyzed CT scans obtained between April 2020 and March 2023, from 31 patients (7 males and 24 females) with MRONJ. We extracted 279 radiomic features from regions of interest defined on the affected and control sides. These features were analyzed using MaZda version 4.6.2.0. Using Fisher’s coefficient, 10 of these features were selected for analysis. The selected features were compared between the affected and control sides using the paired t-test and the Wilcoxon signed-rank test. Significance was set at p < 0.05. Results All selected radiomics features, which were texture features of the mandibular condylar bone marrow, showed significant differences between the affected and control sides in patients with MRONJ (p < 0.05). Conclusions These findings suggested that microstructural changes, not easily detected on visual inspection, may occur in the trabecular structure of the affected mandibular condyle in patients with MRONJ. Therefore, the impact of the disease on the temporomandibular joint should be considered in MRONJ.