Tomoelastography for non-invasive detection of ameloblastoma and metastatic neck lymph nodes

BMJ Case Rep. 2020 Sep 9;13(9):e235930. doi: 10.1136/bcr-2020-235930.


Ameloblastoma is a benign epithelial tumour and the most common odontogenic tumour, accounting for about 18% of cases. We present a patient to illustrate the first use of tomoelastography for quantitatively mapping tissue stiffness (shear wave speed) and fluidity (loss angle of the complex shear modulus) in a metastasised ameloblastoma of the left mandible. Tomoelastography maps clearly depicted the extent of the tumour by abnormally high values of stiffness and fluidity (1.73±0.23 m/s, 1.18±0.08 rad) compared with normal values in the contralateral mandible (1.04±0.09 m/s, 0.93±0.12 rad). Abnormal stiffness also revealed metastatic involvement of the neck lymph nodes (1.30±0.03 m/s vs 0.86±0.01 m/s). Taken together, stiffness and fluidity measured by tomoelastography can sensitively detect the presence and extent of bone tumours and metastatic spread to cervical lymph nodes.

Keywords: head and neck cancer; radiology; screening (oncology).

Publication types

  • Case Reports

MeSH terms

  • Ameloblastoma* / diagnostic imaging
  • Ameloblastoma* / pathology
  • Ameloblastoma* / surgery
  • Cone-Beam Computed Tomography / methods
  • Elasticity Imaging Techniques / methods*
  • Head and Neck Neoplasms* / diagnosis
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnostic imaging*
  • Lymphatic Metastasis / pathology
  • Male
  • Mandibular Neoplasms* / diagnostic imaging
  • Mandibular Neoplasms* / pathology
  • Mandibular Neoplasms* / surgery
  • Middle Aged
  • Neck
  • Neck Dissection / methods*
  • Radiography, Panoramic / methods
  • Treatment Outcome