Ghosh A, Lakshmanan M, Manchanda S, Bhalla AS, Kumar P, Bhutia O, Mridha AR. Contrast-enhanced multidetector computed tomography features and histogram analysis can differentiate ameloblastomas from central giant cell granulomas . World J Radiol 2022; 14(9): 329-341 [PMID: 36186516 DOI: 10.4329/wjr.v14.i9.329]
Corresponding Author of This Article
Ashu Seith Bhalla, MD, Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India. ashubhalla1@yahoo.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Sep 28, 2022; 14(9): 329-341 Published online Sep 28, 2022. doi: 10.4329/wjr.v14.i9.329
Contrast-enhanced multidetector computed tomography features and histogram analysis can differentiate ameloblastomas from central giant cell granulomas
Adarsh Ghosh, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States
Meyyappan Lakshmanan, Smita Manchanda, Department of Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
Ashu Seith Bhalla, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
Prem Kumar, Ongkila Bhutia, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
Asit Ranjan Mridha, Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
Author contributions: Ghosh A contributed to methodology, software; Ghosh A and Lakshmanan M contributed to writing - original draft; Lakshmanan M contributed to investigation; Bhalla AS and Manchanda S contributed to conceptualization; Bhalla AS, Manchanda S, Kumar P, Bhutia O, and Mridha AR contributed to writing - review & editing, supervision; Kumar P, Bhutia O, and Mridha AR contributed to resources.
Institutional review board statement: The study was reviewed and approved by the All India Institute of Medical Science, New Delhi Institutional Review Board [(Approval No.IEC-622/03.07.2020, RP-31/2020)].
Informed consent statement: The requirement of signed consent forms was waived by the Institutional Ethics Board.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ashu Seith Bhalla, MD, Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India. ashubhalla1@yahoo.com
Received: March 19, 2022 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
Abstract
BACKGROUND
No qualitative or quantitative analysis of contrast-enhanced computed tomography (CT) images has been reported for the differentiation between ameloblastomas and central giant cell granulomas (CGCGs).
AIM
To describe differentiating multidetector CT (MDCT) features in CGCGs and ameloblastomas and to compare differences in enhancement of these lesions qualitatively and using histogram analysis.
METHODS
MDCT of CGCGs and ameloblastomas was retrospectively reviewed to evaluate qualitative imaging descriptors. Histogram analysis was used to compare the extent of enhancement of the soft tissue. Fisher’s exact tests and Mann–Whitney U test were used for statistical analysis (P < 0.05).
RESULTS
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 mineralization 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 mineralization was present in 69.7% of cases. Quantitatively, the enhancement of soft tissue in CGCG was significantly higher than in ameloblastoma 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 a CGCG.
CONCLUSION
A multilocular, lytic sclerotic lesion with significant hyperenhancement in soft tissue, which spares the angle of the mandible and has matrix mineralization, should indicate prospective diagnosis of CGCG.
Core Tip: Central giant cell granulomas (CGCGs) are rare tumours of the jaw. This study evaluated the findings of CGCGs on contrast-enhanced computed tomography in contrast with ameloblastomas, which are the most common tumours of the jaw in the developing world.
