Magnetic Resonance Imaging-Based Radiomics Analysis of Cervical Lymph Nodes Associated with Medication-Related Osteonecrosis of the Jaw

To quantitatively evaluate the magnetic resonance imaging (MRI) texture features of cervical lymph nodes (LNs) associated with medication-related osteonecrosis of the jaw (MRONJ). This retrospective exploratory study included 36 women (72 cervical LNs) with or without MRONJ who underwent MRI at our institution between April 2017 and April 2022. The participants were 58–90 years old (mean age, 77.7 years). Radiomic analysis was conducted using manually delineated regions of interest on short tau inversion recovery (STIR) images, from which 279 quantitative features were extracted with MaZda version 3.3. Data normality was evaluated using the Shapiro–Wilk test. Variables with a normal distribution were compared using the independent-samples t-test, whereas non-normally distributed variables were analyzed using the Mann–Whitney U test. p values were adjusted for multiple comparisons using the Benjamini–Hochberg false discovery rate (FDR) procedure. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory performance of the selected texture features. Twenty texture features were selected from the initial 279 features. All 10 selected texture features of the submandibular LNs yielded FDR-adjusted p values < 0.05, whereas none of the selected features of the superior internal jugular LNs met this threshold. ROC analysis demonstrated AUCs ranging from 0.67 to 0.82. MRI radiomics analysis may provide complementary quantitative information for evaluating lymph node alterations associated with MRONJ.