Computed tomography texture analysis of mandibular condylar bone marrow in diabetes mellitus patients

Objectives: Diabetes mellitus (DM) is associated with a broad range of complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular disease. Therefore, predicting DM from head and neck images is a challenge for clinicians. The purpose of this study was to assess the mandibular condylar bone marrow in DM patients using computed tomography (CT) texture analysis. Methods: This retrospective study included 16 DM and age and sex matched 16 control patients (11 men, 5 women; mean age, 56.8 ± 14.4 years; range 31–78 years). Patients with Type I DM, prior history of taking bisphosphonates, osteoarthritis of the temporomandibular joint, and CT images with metal artifacts were excluded from this study. Bilateral mandibular condylar bone marrow was manually contoured on axial CT images. The presence or absence of DM is the primary predictor variable. Texture features of the region of interest was the outcome variable, that were analyzed using an open-access software, MaZda Ver.3.3. For each group, 20 features out of 279 parameters were selected with Fisher, probability of error and average correlation coefficient methods in MaZda. Bivariate statistics were computed with the Mann–Whitney U test and the P value was set at.05. Results: One histogram feature, 15 Gy level co-occurrence matrix features, and four gray level run length matrix features showed differences between the DM patients and non-DM patients (P < 0.05). Conclusions: Several texture features of the condyle demonstrated differences between the DM and non-DM patients. CT texture analysis may potentially detect DM from the condylar bone marrow.