Imaging features contributing to the diagnosis of ameloblastomas and keratocystic odontogenic tumours: logistic regression analysis

Abstract

Objective: The aim of this study was to clarify the characteristic imaging features that can be used to differentiate ameloblastomas from keratocystic odontogenic tumours and to examine the significant imaging features contributing to a correct diagnosis. Methods: 60 observers (39 specialists in oral and maxillofacial radiology and 21 nonspecialists) examined CT and/or panoramic images of 10 ameloblastomas and 10 keratocystic odontogenic tumours shown on a webpage and made diagnoses. Their correct answer ratios were then calculated. The imaging features of the tumours were evaluated and expressed as binary numbers or quantitative values. The imaging features that contributed to a correct diagnosis were elucidated using logistic regression analysis. Results: The mean correct answer ratio was 61.3% ¡ 17.2% for the diagnosis of ameloblastomas and keratocystic odontogenic tumours. CT images produced higher correct answer ratios for diagnosis of keratocystic odontogenic tumours by specialists. The significantly different imaging features between ameloblastomas and keratocystic odontogenic tumours were the degree of bone expansion and the presence of high-density areas. The significant imaging features contributing to a correct imaging diagnosis were the number of locules, the presence of high-density areas and the inclusion of impacted teeth. Conclusion: The presence of high-density areas is the most useful feature in the differential diagnosis of ameloblastomas and keratocystic odontogenic tumours based on comparison of the imaging features of both tumours and examination of the diagnostic contributions of these features.

A Classic Case of Solid Multiloculated Ameloblastoma of the Mandible

“…According to literature odontogenic keratocysts have lower CT density with higher heterogeneity than Ameloblastomas. 5 One of the studies showed a significant difference regarding bony expansion, impacted teeth and high-density areas between the two. 5 According to this study, the presence of highdensity areas is the most useful feature in the differential diagnosis of ameloblastomas and keratocystic odontogenic tumors.…”

Diagnostic contributions of imaging features to differentiate ameloblastomas from keratocystic odontogenic tumours: a commentary

“…In reference to an article by Ariji et al, 1 we would like to thank the authors for an informative study. This article was enlightening owing to the paucity of studies conducted regarding this subject.…”

Estudo comparativo entre radiografia panorâmica e tomografia computadorizada por feixe cônico no diagnóstico de ameloblastoma, tumor odontogênico queratocístico e cisto dentígero

“…Com a enucleação raramente ocorre recorrência (SCHOLL et al, 1999;FREITAS et al, 2006;BUYUKKURT;OMEZLI;MILOGLU, 2010;MACANOVIC, 2010 odontogênico queratocístico e o cisto dentígero podem apresentar aspecto radiográfico indistinguível: uma lesão radiolúcida unilocular, bem definida e corticalizada, frequentemente associada à coroa de um dente impactado ou não irrompido, como também podem apresentar grandes proporções e aspecto multilocular com bordas festonadas. O que torna difícil a hipótese de diagnóstico baseada somente nos aspectos radiográficos (WEBER, 1993;SCHOLL et al, 1999;CHAPELLE et al, 2004;DUNFEE et al, 2006;FREITAS et al, 2006;BOEDDINGHAUS;WHYTE, 2008;MCCREA, 2009;ARIJI et al, 2011;MORGAN, 2011;TITINCHI;NORTJE, 2012;SANSARE et al, 2013 A avaliação foi realizada com o uso de um negatoscópio, com auxílio de uma lupa de 60mm de diâmetro e aumento de 3x, em um ambiente com iluminação adequada. Nenhum dado clínico foi informado.…”

“…O ameloblastoma e o tumor odontogênico queratocístico são os mais frequentes tumores odontogênicos e o cisto dentígero é o mais frequente cisto odontogênico de desenvolvimento e o segundo cisto odontogênico mais comum. A imagem radiográfica pode ser muito semelhante e variar desde uma lesão radiolúcida, unilocular, de borda esclerótica bem definida, a uma lesão radiolúcida extensa, multilocular e de bordas festonadas; frequentemente associadas à coroa de um dente impactado ou não irrompido (WEBER, 1993;SCHOLL et al, 1999;CHAPELLE et al, 2004;DUNFEE et al, 2006;FREITAS et al, 2006;BOEDDINGHAUS;WHYTE, 2008;MCCREA, 2009;ARIJI et al, 2011;MORGAN, 2011;TITINCHI;NORTJE, 2012;SANSARE et al, 2013).…”

“…Neste aspecto, a quantidade de pesquisas utilizando exames de TC (YOSHIURA et al, 1994;FUKUDA, 2001;CAVALCANTI;ANTUNES, 2002;CIHANGIROGLU;AKFIRAT;YILDIRIM, 2002;HAYASHI et al, 2002;GÜMGÜM;HOŞGÖREN, 2005;CRUSOÉ-REBELLO et al, 2009;APAJALAHTI et al, 2011;ARIJI et al, 2011) é maior quando comparada à quantidade de pesquisas realizadas com o uso da TCFC (GUTTENBERG, 2008;SINGER;PHILIPONE, 2009;KOÇAK-BERBEROĞLU et al, 2012;LUO et al, 2014).…”