Visualising cervical lymph nodes in jaw osteonecrosis using diffusion-weighted imaging

Objectives: This study aimed to apply diffusion-weighted imaging to the evaluation of cervical lymph nodes affected by medication-related osteonecrosis of the jaw (MRONJ). Methods: This retrospective study analysed the diffusion-weighted imaging data of 70 patients with or without MRONJ (Stages 0–3). The mean apparent diffusion coefficient (ADC) values of the submandibular (level IB) and superior internal jugular (level IIA) nodes in the control and MRONJ groups were calculated, and differences were analysed using the Mann–Whitney test. Moreover, receiver operating characteristic (ROC) curve analysis was performed to evaluate the ability of ADC values to predict lymph nodes that were affected by MRONJ. p < 0.05 was considered statistically significant. Results: The median [interquartile range] (×10⁻³ mm²/s) of level IB was 0.74 [0.7–0.81] and 0.93 [0.84–1.09] and that of level IIA was 0.79 [0.76–0.85] and 0.97 [0.84–1.06] in the control and MRONJ groups respectively. ROC analysis revealed that the ADC value had excellent ability to discriminate between the control and MRONJ groups. Conclusions: The study findings indicate that diffusion-weighted imaging can contribute to differentiation of MRONJ from other cervical lymph node diseases and facilitate early detection of MRONJ.