MASCC/ISOO Clinical Practice Statement: imaging and clinical laboratory tests in the diagnosis and management of medication-related osteonecrosis of the jaw

Abstract

PurposeA MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise resource for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS focuses on the use of imaging and clinical laboratory tests for the diagnosis, staging, monitoring, treatment decision, and prediction of medication-related osteonecrosis of the jaw (MRONJ) in cancer patients.MethodsThis CPS was developed based on a critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group (OCSG) of MASCC/ISOO. The information is presented in the form of succinct bullets and tables to generate a short manual about the best standard of care.ResultsRadiographs, cone beam computerized tomography (CT), conventional CT, magnetic resonance imaging (MRI), and nuclear imaging are often utilized in patients with MRONJ. The CPS describes the considerations for selecting each imaging modality. Laboratory workup in patients with MRONJ is often derived by comorbidities, with immune status and bleeding tendency being the key considerations.ConclusionImaging and lab tests have an important role in the diagnosis and management of MRONJ. The imaging modality and specific laboratory tests should be tailored to the patient's needs.