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Objectives <p>To evaluate whether quantitative parameters derived from dual-energy computed tomography (DECT), combined with conventional imaging features, can effectively distinguish between ameloblastomas and odontogenic keratocysts (OKCs) with solid components.</p> Materials and methods <p>This retrospective analysis evaluated patients with pathologically confirmed ameloblastomas or OKCs who underwent multiphase contrast-enhanced dual-energy CT examinations between January 2020 and July 2024. Quantitative DECT parameters and conventional radiological characteristics were compared. Multivariate analysis identified predictors, and the receiver operating characteristic (ROC) curve assessed performance.</p> Results <p>A total of 28 ameloblastomas and 20 OKCs with solid components were evaluated. Ameloblastomas exhibited significantly higher RHO values in the unenhanced, arterial, and venous phases than those in OKCs (<i>p</i> &lt; 0.001 to 0.002), elevated venous-phase Zeff, IC, NIC, and λ<sub>HU</sub> (<i>p</i> &lt; 0.001), larger lesion dimensions, greater expansion (<i>p</i> &lt; 0.008), and pronounced bone resorption (<i>p</i> &lt; 0.001). Conversely, OKCs demonstrated significantly higher FAT and DEI values in the unenhanced and venous phases (<i>p</i> &lt; 0.001 to 0.043). Multivariate logistic regression analysis identified that λ<sub>HU</sub> (95% confidence interval 1.195–1.807, <i>p</i> &lt; 0.001), NIC (95% CI 1.069–1.262, <i>p</i> &lt; 0.001) in the venous phase, and maximum dimension (95% CI 1.05–1.252, <i>p</i> = 0.002) are independent predictors. A combined model incorporating these parameters demonstrated superior diagnostic performance to differentiate ameloblastomas from OKCs (AUC: 0.963; sensitivity: 85.71%; specificity: 100%).</p> Conclusions <p>The combination of DECT quantitative parameters with conventional imaging features significantly improves differentiating ameloblastomas from OKCs with solid components, offering a potential imaging-based diagnostic tool for clinical decision-making.</p>

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Dual-energy CT quantitative parameters can improve the performance of differential diagnostic between ameloblastomas and odontogenic keratocysts with solid components

  • 期刊论文

  • 发表日期：

    2025年10月24日

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  • Yusong Jiang,
  • Xing Wu,
  • Wenshi Chen,
  • Lingjie Yang,
  • Yu Wang,
  • Guoxiong Lu,
  • Lu Yang,
  • Riyu Han,
  • Xiaohui Duan,
  • Yun Su

摘要

Objectives

To evaluate whether quantitative parameters derived from dual-energy computed tomography (DECT), combined with conventional imaging features, can effectively distinguish between ameloblastomas and odontogenic keratocysts (OKCs) with solid components.

Materials and methods

This retrospective analysis evaluated patients with pathologically confirmed ameloblastomas or OKCs who underwent multiphase contrast-enhanced dual-energy CT examinations between January 2020 and July 2024. Quantitative DECT parameters and conventional radiological characteristics were compared. Multivariate analysis identified predictors, and the receiver operating characteristic (ROC) curve assessed performance.

Results

A total of 28 ameloblastomas and 20 OKCs with solid components were evaluated. Ameloblastomas exhibited significantly higher RHO values in the unenhanced, arterial, and venous phases than those in OKCs (p < 0.001 to 0.002), elevated venous-phase Zeff, IC, NIC, and λHU (p < 0.001), larger lesion dimensions, greater expansion (p < 0.008), and pronounced bone resorption (p < 0.001). Conversely, OKCs demonstrated significantly higher FAT and DEI values in the unenhanced and venous phases (p < 0.001 to 0.043). Multivariate logistic regression analysis identified that λHU (95% confidence interval 1.195–1.807, p < 0.001), NIC (95% CI 1.069–1.262, p < 0.001) in the venous phase, and maximum dimension (95% CI 1.05–1.252, p = 0.002) are independent predictors. A combined model incorporating these parameters demonstrated superior diagnostic performance to differentiate ameloblastomas from OKCs (AUC: 0.963; sensitivity: 85.71%; specificity: 100%).

Conclusions

The combination of DECT quantitative parameters with conventional imaging features significantly improves differentiating ameloblastomas from OKCs with solid components, offering a potential imaging-based diagnostic tool for clinical decision-making.