Abstract
Ameloblastoma commonly arise in the mandible and are characterized by local invasiveness and a high recurrence rate. Therefore, accurate assessment of the extent of bony invasion before surgery is critical. However, such assessments rely largely on the experience of radiologists and surgeons, and no objective or reproducible quantitative methods have yet been established. This study aimed to evaluate the clinical utility of relative computed tomography values (rCTv) in determining tumor invasion in ameloblastoma. In this study, six male patients who underwent segmental resection between September 2022 and May 2025 were included. Preoperative computed tomography (CT) images were analyzed using a 3D Slicer to obtain CT values (CTv) from both lesional and non-lesional sites, from whic1h rCTv was calculated. Additionally, clinician-determined CTv and rCTv were derived based on tumor boundaries delineated by eight board-certified oral surgeons, and inter-case variability was analyzed using t-tests. Clinician-determined CTv demonstrated considerable variability across cases, with significant differences in seven out of 15 comparisons. In contrast, the clinician-determined rCTv showed reduced variability, with significant differences observed in only four out of 15 comparisons. The clinical threshold for rCTv was found to lie within the range of 27.83-36.48%. This value obtained in this study can be regarded as a suitable candidate for defining a clinical threshold. This method may serve as an objective reference for determining surgical margins preoperatively and has potential applications as a diagnostic support tool.
