Effectiveness of 18 F-sodium fluoride positron emission tomography/computed tomography scan in the early detection of periradicular lesions

Objective: Establishing the correct diagnosis is key for the implementation of adequate therapy. The aim of this study was to analyze the sensitivity of 18 F-sodium fluoride positron emission tomography/computed tomography (PET/CT), in comparison with conventional radiographic imaging techniques (periapical/parallelism technique and panoramic radiographs), in the early detection of periradicular lesions. Materials and Methods: A total of 256 maxillary and mandibular areas from eight patients were randomly selected for analysis using conventional radiographic techniques and PET/CT. The nuclear image acquisition protocol included scans from the top of the head to the middle third of the neck region. After analysis of the images obtained with different methods (periapical vs. panoramic radiography, and radiography vs. PET/CT). The number of images with positive findings for infection were compared using ANOVA (P ≤ 0.05). Results: There were no significant differences in the number of positive images between the two conventional radiographic techniques: Six (2.34% of the sample) and seven (2.73%) positive images were found among panoramic and periapical radiographs, respectively. Conversely, PET/CT yielded 39 (15.23% of the sample) images positive for infection, significantly higher number when compared with the two conventional radiographic techniques assessed. Conclusion: Positron emission tomography/computed tomography showed to be more effective than conventional radiography in the early detection of dental infection. These findings allow to suggest that the use of PET/CT in endodontics would significantly contribute to the early and accurate diagnosis of periradicular lesions.