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Use of FDG PET to evaluate hyperbaric oxygen therapy for bisphosphonate-related osteonecrosis of the jaw.

An 80-year-old man presented with painful swelling in the mandibular region and a fistula with pus discharge that developed after tooth extractions. He had taken oral alendronate sodium hydrate and prednisolone for osteoporosis for 5 years. The lesion was diagnosed as bisphosphonate-related osteonecrosis of the jaw. Fluorodeoxyglucose positron emission tomography (FDG PET) revealed a high accumulation of FDG in the right mandibular region. The patient underwent hyperbaric oxygen therapy (HBO) 20 times. FDG PET maximum standard uptake value drastically decreased from 5.6 to 1.8 after HBO, paralleling the change in clinical symptoms, whereas other modalities did not show remarkable changes. This study demonstrates the utility of FDG PET in monitoring HBO for bisphosphonate-related osteonecrosis of the jaw.