Intraoperative efficiency of fluorescence imaging by Visually Enhanced Lesion Scope (VELscope(®)) in patients with bisphosphonate related osteonecrosis of the jaw (BRONJ)

TY - JOUR

T1 - Intraoperative efficiency of fluorescence imaging by Visually Enhanced Lesion Scope (VELscope(®)) in patients with bisphosphonate related osteonecrosis of the jaw (BRONJ)

AU - Assaf, Alexandre T

AU - Zrnc, Tomislav A

AU - Riecke, Björn

AU - Wikner, Johannes

AU - Zustin, Josef

AU - Friedrich, Reinhard E

AU - Heiland, Max

AU - Smeets, Ralf

AU - Gröbe, Alexander

N1 - Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

PY - 2014

Y1 - 2014

N2 - OBJECTIVES: The purpose of this study was to determine the potential of tissue fluorescence imaging by using Visually Enhanced Lesion Scope (VELscope(®)) for the detection of osteonecrosis of the jaw induced by bisphosphonates (BRONJ).METHODS: We investigated 20 patients (11 females and 9 males; mean age 74 years, standard deviation ± 6.4 years), over a period of 18 month with the diagnosis of BRONJ in this prospective cohort study. All patients received doxycycline as a fluorescending marker for osseous structures. VELscope(®) has been used intraoperatively using the loss of fluorescence to detect presence of osteonecrosis. Osseous biopsies were taken to confirm definite histopathological diagnosis of BRONJ in each case.RESULTS: Diagnosis of BRONJ was confirmed for every patient. In all patients except one, VELscope(®) was sufficient to differentiate between healthy and necrotic bone by visual fluorescence retention (VFR) and visual fluorescence loss (VFL). 19 cases out of a total of 20 showed no signs of recurrence of BRONJ during follow-up (mean 12 months, range 4-18 months).CONCLUSION: VELscope(®) examination is a suitable tool to visualize necrotic areas of the bone in patients with bisphosphonate related osteonecrosis of the jaw. Loss of fluorescence in necrotic bone areas is useful intraoperatively as a tool for fluorescence-guided bone resection with relevant clinical interpretation.

AB - OBJECTIVES: The purpose of this study was to determine the potential of tissue fluorescence imaging by using Visually Enhanced Lesion Scope (VELscope(®)) for the detection of osteonecrosis of the jaw induced by bisphosphonates (BRONJ).METHODS: We investigated 20 patients (11 females and 9 males; mean age 74 years, standard deviation ± 6.4 years), over a period of 18 month with the diagnosis of BRONJ in this prospective cohort study. All patients received doxycycline as a fluorescending marker for osseous structures. VELscope(®) has been used intraoperatively using the loss of fluorescence to detect presence of osteonecrosis. Osseous biopsies were taken to confirm definite histopathological diagnosis of BRONJ in each case.RESULTS: Diagnosis of BRONJ was confirmed for every patient. In all patients except one, VELscope(®) was sufficient to differentiate between healthy and necrotic bone by visual fluorescence retention (VFR) and visual fluorescence loss (VFL). 19 cases out of a total of 20 showed no signs of recurrence of BRONJ during follow-up (mean 12 months, range 4-18 months).CONCLUSION: VELscope(®) examination is a suitable tool to visualize necrotic areas of the bone in patients with bisphosphonate related osteonecrosis of the jaw. Loss of fluorescence in necrotic bone areas is useful intraoperatively as a tool for fluorescence-guided bone resection with relevant clinical interpretation.

U2 - 10.1016/j.jcms.2013.07.014

DO - 10.1016/j.jcms.2013.07.014

M3 - SCORING: Journal article

C2 - 24011463

VL - 42

SP - e157-e164

JO - J CRANIO MAXILL SURG

JF - J CRANIO MAXILL SURG

SN - 1010-5182

IS - 5

ER -