Black Bone MRI Morphometry for Mandibular Cortical Bone Measurement in Head and Neck Cancer Patients: Prospective Method Comparison With CT

Authors

Lisanne V van Dijk
Juan Ventura
Kareem A Wahid
Lin L Zhu
Brigid A McDonald
Sara Ahmed
Keith L Sanders
Sonja M Stieb
Lance McCoy
Christina S Sharafi
Kathryn E Preston
Natalie A West
Sarah Mirbahaeddin
Dina M El-Habashy
Travis Salzillo
Samuel Mulder
Joly Fahim
Aubryane DeArmas
Mona Arbab
Yao Ding
Jihong Wang
Bastien Rigaud
Anando Sen
Mark Chambers
Katherine A Hutcheson
Kristy K Brock
Abdallah S R Mohamed
Stephen Y Lai
Clifton D Fuller

Language

English

Publication Date

12-29-2025

Journal

Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology

DOI

10.1016/j.oooo.2025.12.013

PMID

41702795

PMCID

PMC12962360

PubMedCentral® Posted Date

3-6-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Objectives: Determine the utility of low-flip angle "black bone" magnetic resonance imaging (MRI) for cortical mandibular bone assessment compared to computed tomography (CT).

Methods: Quantification of cortical mandibular bone width was performed per Hamada et al. at 15 cross-sectional interdentium locations on pretreatment black bone MRI and CT for 15 oropharyngeal cancer patients, with interobserver analyses on a subset of three patients by 11 observers. CT and MRI measurements were compared using Bland-Altman analysis, Lin's concordance, and Deming regression; interobserver variability was assessed with absolute variance and intraclass correlation coefficient (ICC).

Results: Bland Altman and Deming regression analyses showed CT and black bone MRI measurements were comparable within ±0.85mm limits of agreement, and systematically smaller for MRI. ICC (0.60[0.52;0.67]) showed moderate equivalence between modalities. The average absolute variance between the observers was similar on CT (1.13±0.06mm) and MRI (1.15±0.06mm). ICC analysis showed that measurement consistency was significantly higher (p< 0.001) for black bone MRI (0.43[0.32;0.56]) than CT (0.22[0.13;0.35]); nonetheless, ICC was poor for both modalities.

Conclusion: Black bone MRI is a viable alternative to CT for assessing mandibular cortical bone and early detection of anatomical changes like osteoradionecrosis. Both modalities showed similar interobserver variability, which may be reduced through (semi)automated measurement.

Published Open-Access

yes

Recommended Citation

van Dijk, Lisanne V; Ventura, Juan; Wahid, Kareem A; et al., "Black Bone MRI Morphometry for Mandibular Cortical Bone Measurement in Head and Neck Cancer Patients: Prospective Method Comparison With CT" (2025). Faculty, Staff and Student Publications. 6043.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/6043