Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT

Joint Head and Neck MRI-Radiotherapy Development Cooperative; Lisanne V. van Dijk; Juan Ventura; Kareem Wahid; Lin L. Zhu; Brigid A. McDonald; Sara Ahmed; Keith 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

doi:10.1016/j.oooo.2025.12.013

Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT

Joint Head and Neck MRI-Radiotherapy Development Cooperative, Lisanne V. van Dijk, Juan Ventura, Kareem Wahid, Lin L. Zhu, Brigid A. McDonald, Sara Ahmed, Keith 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 ArbabYao 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^*

^*Corresponding author for this work

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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 pre-treatment black bone MRI and CT for 15 oropharyngeal cancer patients, with inter-observer analyses on a subset of 3 patients by 11 observers. CT and MRI measurements were compared using Bland-Altman analysis, Lin’s concordance, and Deming regression; inter-observer 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

Original language	English
Pages (from-to)	690-700
Number of pages	11
Journal	Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Volume	141
Issue number	5
Early online date	29 Dec 2025
DOIs	https://doi.org/10.1016/j.oooo.2025.12.013
Publication status	Published - 1 May 2026
Externally published	Yes

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SDG 3 Good Health and Well-being

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10.1016/j.oooo.2025.12.013

PIIS2212440325013872Accepted author manuscript, 1.1 MBLicence: CC BY

Cite this

Joint Head and Neck MRI-Radiotherapy Development Cooperative, van Dijk, L. V., Ventura, J., Wahid, K., Zhu, L. L., McDonald, B. A., Ahmed, S., Sanders, K., Stieb, S. M., McCoy, L., Sharafi, C. S., Preston, K. E., West, N. A., Mirbahaeddin, S., El-Habashy, D. M., Salzillo, T., Mulder, S., Fahim, J., DeArmas, A., ... Fuller, C. D. (2026). Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 141(5), 690-700. https://doi.org/10.1016/j.oooo.2025.12.013

@article{f4f058a1463e447d8dd808c7a879781f,

title = "Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT",

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 pre-treatment black bone MRI and CT for 15 oropharyngeal cancer patients, with inter-observer analyses on a subset of 3 patients by 11 observers. CT and MRI measurements were compared using Bland-Altman analysis, Lin{\textquoteright}s concordance, and Deming regression; inter-observer 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",

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

year = "2026",

month = may,

day = "1",

doi = "10.1016/j.oooo.2025.12.013",

language = "English",

volume = "141",

pages = "690--700",

journal = "Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology",

issn = "2212-4403",

publisher = "Elsevier",

number = "5",

}

Joint Head and Neck MRI-Radiotherapy Development Cooperative, van Dijk, LV, Ventura, J, Wahid, K, Zhu, LL, McDonald, BA, Ahmed, S, Sanders, K, Stieb, SM, McCoy, L, Sharafi, CS, Preston, KE, West, NA, Mirbahaeddin, S, El-Habashy, DM, Salzillo, T, Mulder, S, Fahim, J, DeArmas, A, Arbab, M, Ding, Y, Wang, J, Rigaud, B, Sen, A, Chambers, M, Hutcheson, KA, Brock, KK, Mohamed, ASR, Lai, SY & Fuller, CD 2026, 'Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT', Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, vol. 141, no. 5, pp. 690-700. https://doi.org/10.1016/j.oooo.2025.12.013

Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT. / Joint Head and Neck MRI-Radiotherapy Development Cooperative; van Dijk, Lisanne V.; Ventura, Juan et al.
In: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Vol. 141, No. 5, 01.05.2026, p. 690-700.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT

AU - Joint Head and Neck MRI-Radiotherapy Development Cooperative

AU - van Dijk, Lisanne V.

AU - Ventura, Juan

AU - Wahid, Kareem

AU - Zhu, Lin L.

AU - McDonald, Brigid A.

AU - Ahmed, Sara

AU - Sanders, Keith

AU - Stieb, Sonja M.

AU - McCoy, Lance

AU - Sharafi, Christina S.

AU - Preston, Kathryn E.

AU - West, Natalie A.

AU - Mirbahaeddin, Sarah

AU - El-Habashy, Dina M.

AU - Salzillo, Travis

AU - Mulder, Samuel

AU - Fahim, Joly

AU - DeArmas, Aubryane

AU - Arbab, Mona

AU - Ding, Yao

AU - Wang, Jihong

AU - Rigaud, Bastien

AU - Sen, Anando

AU - Chambers, Mark

AU - Hutcheson, Katherine A.

AU - Brock, Kristy K.

AU - Mohamed, Abdallah S.R.

AU - Lai, Stephen Y.

AU - Fuller, Clifton D.

PY - 2026/5/1

Y1 - 2026/5/1

N2 - 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 pre-treatment black bone MRI and CT for 15 oropharyngeal cancer patients, with inter-observer analyses on a subset of 3 patients by 11 observers. CT and MRI measurements were compared using Bland-Altman analysis, Lin’s concordance, and Deming regression; inter-observer 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

AB - 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 pre-treatment black bone MRI and CT for 15 oropharyngeal cancer patients, with inter-observer analyses on a subset of 3 patients by 11 observers. CT and MRI measurements were compared using Bland-Altman analysis, Lin’s concordance, and Deming regression; inter-observer 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

UR - https://www.scopus.com/pages/publications/105028660312

U2 - 10.1016/j.oooo.2025.12.013

DO - 10.1016/j.oooo.2025.12.013

M3 - Article

SN - 2212-4403

VL - 141

SP - 690

EP - 700

JO - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

JF - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

IS - 5

ER -

Joint Head and Neck MRI-Radiotherapy Development Cooperative, van Dijk LV, Ventura J, Wahid K, Zhu LL, McDonald BA et al. Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2026 May 1;141(5):690-700. Epub 2025 Dec 29. doi: 10.1016/j.oooo.2025.12.013

Black bone MRI morphometry for mandibular cortical bone measurement in head and neck cancer patients: Prospective method comparison with CT

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