Lesion Expansion in Gnathic Fibrous Dysplasia: Natural History, Indicators of Progression, and Response to Bisphosphonates
Authors' conclusion
Gnathic FD lesion expansion is most rapid in younger children and declines as patients approach adulthood.
Study context
- Population
- Patients with gnathic fibrous dysplasia (FD), with or without McCune-Albright syndrome, and serial CT imaging; median age at initial scan 8.8 years (range 3.4–18.8)
- Participants
- 52 patients104 lesions
- Outcome
- FD lesion volume (volumetric CT analysis)
Methodological detailsserial CT imaging, volumetric analysis, generalized mixed model, Median follow-up imaging: median 4 scans per subject (range 2-14); median age at final scan 16.8 years (range 6.9-33.4 years)
- Serial CT imaging
- Volumetric analysis
- Generalized mixed model
- Median follow-up imaging: median 4 scans per subject (range 2-14); median age at final scan 16.8 years (range 6.9-33.4 years)
Main finding
As reported in the abstract
FD lesion volume
Increase in lesion volume with age, cm³/yr
2.50
95% CI 1.95–3.04p < 0.001
Change in lesion expansion rate over time, cm³/yr
−0.05
95% CI −0.07 to 0.04p < 0.001
Observational data: associations, not effects.
Further findings
Risk factors for lesion expansion
- Mandibular lesions tended to expand at a greater rate than maxillary lesions
- P < 0.001
- GH excess associated with accelerated expansion rate
- P = 0.002
- Other McCune-Albright syndrome (MAS)-associated endocrinopathies, pubertal status, sex, weight, lesion density, disease severity and bisphosphonate treatment not associated with lesion volume or expansion
Original publication
Lesion Expansion in Gnathic Fibrous Dysplasia: Natural History, Indicators of Progression, and Response to Bisphosphonates. J Bone Miner Res. Published 31 July 2023. doi:10.
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