Use of Spherical Segmentation Radiomic Analysis for Differentiation of Odontogenic Keratocysts and Radicular Cysts

Seki U., Kuran A., Üzel A., Baysal O., Çelik S., Sinanoğlu E. A.

International Archives of Dental Sciences , cilt.47, sa.1, ss.49-58, 2026 (Hakemli Dergi)

Özet

ABSTRACT

INTRODUCTION: The objective of this study was to investigate the potential of radiomics in distinguishing between odontogenic keratocyst, a developmental odontogenic cyst, and radicular cyst, an inflammatory odontogenic cyst.

MATERIAL and METHODS: This retrospective case-control study included 10 patients with odontogenic keratocysts who were admitted to the Department of Oral and Maxillofacial Radiology. The control group consisted of patients diagnosed with radicular cysts. Radiomic analysis was performed on the cone-beam computed tomography images of the lesions using a three-dimensional spherical segmentation centered on the lesion. From a total of 93 radiomic features, the most relevant features for lesion differentiation were selected using a Lasso regression model. Based on this analysis, four radiomic features were identified as most strongly associated with the differentiation of the two lesion types. Subsequently, a radiomic score for each patient was calculated as the linear combination of the coefficients of the selected features.

RESULTS: The calculated radiomic scores predicted radicular cysts with a sensitivity and specificity of 80%. The model correctly classified 80% of radicular cysts and 80% of odontogenic keratocysts. Additionally, radiomic scores were found to be higher in radicular cyst patients compared to odontogenic keratocyst patients (OR: 25.251; p = 0.018).

CONCLUSION: Radiomic features enabled the differentiation between radicular cysts and odontogenic keratocysts. However, the findings of this study should be interpreted as preliminary, considering the sample size and study limitations. Nonetheless, the proposed approach has the potential to assist in the differential diagnosis between odontogenic keratocysts and radicular cysts, and to provide clinically valuable insights as a non-invasive virtual biopsy method prior to surgery. Keywords: Radiomics, CBCT, Biopsy, Odontogenic Keratocyst, Radicular Cyst