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 techniques are crucial to accurately identify parathyroid adenomas for preoperative planning. One such modality is 4D-CT which has demonstrated equivalent or superior performance to sestamibi SPECT and ultrasound [4,5]. The goal of the present study is to use 4D-CT radiomic data of lymph nodes and pathology-proven parathyroid adenomas to identify unique quantifiable imaging features of parathyroid adenomas. This may be a method to improve the reliability of parathyroid adenoma detection to promote unilateral minimally invasive parathyroidectomy (MIP).