Clinical application of computed tomography in differential diagnosis of malignant and benign lesions in maxilla

Our aim was to identify the computed tomographic (CT) characteristics most useful to differentiate malignant maxillary tumors (MMTs) from benign maxillary lesions (BML). A retrospective review of CT findings was performed in patients with histopathologically confirmed, untreated maxillary lesions. Logistic regression analysis was performed to evaluate the associations between CT characteristics and malignancy. Patients were divided into three groups according to the summed scores of five CT characteristics. We identified 159 patients with MMT and 132 patients with BML. After multivariable analyses, patients with MMT remained more likely to have cortical destruction and soft tissue extension than those with BML (odds ratio [OR], 49.9, 95% confidence interval [CI], 4.4-560.5 and OR, 17.5, 95% CI, 6.9-44.3, respectively). Compared with a summed CT score of <2, patients with a score of 2-4 and >= 4 were 20 and 430 times more likely to have MMT (OR, 20.1, 95% CI, 4.3-94.7 and OR, 430.5, 95% CI, 87.6-2015.7, respectively). CT provides valuable information about differentiating malignant and benign maxillary lesions, particularly the presence of cortical involvement and soft tissue extension. The value of multi-parametric CT may highly increase such a differential diagnosis. Larger studies are needed to validate our findings.