Published online Sep 28, 2022. doi: 10.4329/wjr.v14.i9.329
Peer-review started: March 19, 2022
First decision: June 16, 2022
Revised: July 5, 2022
Accepted: September 2, 2022
Article in press: September 2, 2022
Published online: September 28, 2022
Processing time: 187 Days and 5.3 Hours
Contrast-enhanced multidetector computed tomography (MDCT) can provide unique information about ameloblastomas and central giant cell granulomas (CGCGs).
To evaluate contrast-enhanced multidetector computed tomography (MDCT) features of ameloblastomas and CGCGs.
To describe differentiating MDCT features in CGCGs and ameloblastomas and to compare the differences in the enhancement of these two lesions qualitatively and using histogram analysis.
MDCTs of CGCGs and ameloblastomas were retrospectively reviewed to evaluate qualitative imaging descriptors. Histogram analysis was used to compare the extent of enhancement of the soft tissue. Fisher’s exact test and Mann–Whitney U test were used for statistical analysis (P < 0.05).
Twelve CGCGs and 33 ameloblastomas were reviewed. Ameloblastomas had a predilection for the posterior mandible with none of the CGCGs involving the angle. CGCGs were multilocular (58.3%), with a mixed lytic sclerotic appearance (75%). Soft tissue component was present in 91% of CGCGs, which showed hyperenhancement (compared to surrounding muscles) in 50% of cases, while the remaining showed isoenhancement. Matrix mineralisation was present in 83.3% of cases. Ameloblastomas presented as a unilocular (66.7%), lytic (60.6%) masses with solid components present in 81.8% of cases. However, the solid component showed isoenhancement in 63%. No matrix mineralisation was present in 69.7% of cases. Quantitatively, the enhancement of soft tissue in CGCGs was significantly higher than in ameloblastomas on histogram analysis (P < 0.05), with a minimum enhancement of > 49.05 HU in the tumour, providing 100% sensitivity and 85% specificity in identifying CGCG.
A multilocular, lytic sclerotic lesion with significant hyperenhancing soft tissue component, which spares the angle of the mandible and has matrix mineralisation, should indicate a prospective diagnosis of CGCG.
Future studies can evaluate the role of perfusion imaging for differentiating these two tumour types.