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Congress: ECR25
Poster Number: C-10473
Type: Poster: EPOS Radiologist (scientific)
Authorblock: M. H. Zhang, C. Ezenekwe, I. Hussain, D. T. Ginat; Chicago/US
Disclosures:
Michael Hanzhe Zhang: Nothing to disclose
Chime Ezenekwe: Nothing to disclose
Irfan Hussain: Nothing to disclose
Daniel Thomas Ginat: Nothing to disclose
Keywords: Ear / Nose / Throat, CT, Computer Applications-Detection, diagnosis, Tissue characterisation
Purpose Primary hyperparathyroidism (PHPT) is the third common endocrine disorder characterized by blood serum parathyroid hormone (PTH) levels of greater than 8 pmol/L and/or a serum calcium level higher than 2.60 mmol/L [1,2]. The majority of cases, approximately 89%, are induced by a single parathyroid adenoma [3]. While PHPT may present asymptomatically, PHPT is classically associated with a myriad of adverse symptoms such as renal, cognitive and/or skeletal abnormalities. Parathyroidectomy is the only curative treatment of PHPT. As such, noninvasive imaging...
Read more Methods and materials 51 subjects with history of 4D neck CT, parathyroidectomy, and pathology proven parathyroid adenoma(s) were retrospectively reviewed for this study. Two anatomical structures (parathyroid adenoma and cervical lymph node) were manually segmented on a 4D CT 25 sec arterial phase CT reconstructed to a slice thickness of 3mm. Segmentation was performed by a medical student or diagnostic radiology resident under the supervision of an attending neuroradiologist. Manual segmentation was performed with 3D Slicer, an open source image computing platform. Radiomic...
Read more Results 13 first order features and 15 second order feature variables demonstrated a statistically significant difference (p<0.0001). Some first order features which were significantly different between parathyroid adenomas and lymph nodes included the minimum, mean, median and 90th percentile Hounsfield unit, indicating significant differences in the CT density of the two anatomical structures (Table 1). This is expected given the arterial hyperenhancement of parathyroid adenomas on arterial phase imaging. There are also several second order radiomic features that were significantly different...
Read more Conclusion Our analysis identified unique first and second order radiomic features that may be used to differentiate parathyroid adenomas from neck lymph nodes on 4D CT. This study was performed retrospectively and at a single institution. Further evaluation with a larger cohort will be useful to develop a radiomic ‘signature’ or model that combines multiple shape, first order and second order features to determine whether a structure is a parathyroid adenoma or lymph node. Further work may also include usage of...
Read more References 1. van Dalen A, Smit CP, van Vroonhoven TJMV, Burger H, de Lange EE. Minimally Invasive Surgery for Solitary Parathyroid Adenomas in Patients with Primary Hyperparathyroidism: Role of US with Supplemental CT. Radiology. 2001 Sep;220(3):631–9.2. Kelly HR, Bunch PM. Parathyroid Computed Tomography: Pearls, Pitfalls, and Our Approach. Neuroimaging Clin N Am. 2022 May;32(2):413–31.3. Johnson NA, Tublin ME, Ogilvie JB. Parathyroid Imaging: Technique and Role in the Preoperative Evaluation of Primary Hyperparathyroidism. Am J Roentgenol. 2007 Jun;188(6):1706–15. 4. Hunter G, Schellingerhout D,...
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