Accuracy of Grayscale Value in Diagnosis of Odontogenic Keratocyst and Radicular Cyst Publisher

Summary: Can a grayscale value distinguish between radicular cysts and odontogenic keratocysts? A study found no significant difference, raising questions about diagnostic reliability. #DentalResearch #3DImaging

Niknami M ; Hoseini AA ; Bayati M
Source: Frontiers in Dentistry Published:2026

Abstract

Objectives: Radicular cyst (RC) and odontogenic keratocyst (OKC) are among the most commonly identified cysts in both the maxilla and mandible. With the advancements in 3D imaging techniques such as cone-beam computed tomography (CBCT), there is an opportunity to thoroughly examine the boundaries of these lesions and quantify the grayscale of CBCT images, known as the grayscale value (GSV). This study investigated the reliability of CBCT GSV in distinguishing between RC and OKC. Materials and Methods: A total of 60 specimens with confirmed pathological diagnoses of RC and OKC were meticulously selected. Before surgical biopsy of each lesion, CBCT images were obtained and analyzed using Romexis version 2.9.2 software to compute the mean GSV of each lesion. Statistical analysis was then conducted using SPSS version 1.0.0.1406, and a linear, backward regression model was used to analyze the differences in GSV between lesion categories (alpha=0.05). Results: Upon extracting the mean GSV of the selected sections of each type of lesion, no statistically significant difference was observed between the mean GSVs of the two lesion categories (P>0.05). Conclusion: The present findings regarding lack of a significant difference in the mean GSV between RC and OKC were substantial, and suggest that the GSV may not be a reliable index for differentiating these cystic lesions from each other, a conclusion that could potentially impact future diagnostic practices. Copyright © 2026 The Authors.