Abstract
Aim: The study aimed to correlate radiomic data of four-dimensional computed tomography (4D-CT) with pathology-proven parathyroid adenomas to identify and quantitate select dimensional and textural features that predict parathyroid adenomas with a high degree of confidence, with the ultimate goal of improving the reliability of parathyroid adenoma detection so as to facilitate the subsequent unilateral minimally invasive parathyroidectomy (MIP).
Methods: A total of 144 subjects with a history of neck 4D-CT, parathyroidectomy, and intraoperative pathology-proven parathyroid adenoma(s) were retrospectively reviewed. Following the exclusion of patients with a thyroidectomy, unsuccessful surgery, or indeterminate localization of the parathyroid adenoma on 4D-CT, a preliminary sample of 20 patients was obtained. Four anatomical structures (carotid artery, internal jugular vein, thyroid, and parathyroid adenoma) were segmented twice on 25-second arterial phase axial sections of a 4D-CT, and radiomic data of the shape, first-order, and second-order classes (106 variables) were extracted from the four structures for each patient.
Results: Select radiomic variables among the carotid artery, jugular vein, and thyroid groups exhibited overall significant differences when compared to the parathyroid adenoma data (P < 0.05). Further Tukey’s post hoc analysis revealed that, when the parathyroid adenoma group was treated as the reference, 11/16 shape class, 16/18 first-order class, and 46/69 second-order class variables significantly differ from the carotid artery, jugular vein, and/or thyroid group(s). In addition, we found that the thyroid has distinct textural features compared to the parathyroid group, with 1/18 first-order and 19/69 second-order variables differing significantly between the two (P < 0.05). Notably, the texture variables such as dependence non-uniformity, long run emphasis, run percentage, run variance, and busyness exhibited the highest level of differences between the two groups (P < 0.0001).
Conclusion: The parathyroid adenoma group is associated with a unique set of radiomic variables in comparison to surrounding anatomy such as the carotid artery, internal jugular vein, and thyroid.
Relevance for Patients: The distinct, quantifiable differences in dimensional and textural features serve as a set of signature markers distinguishing parathyroid adenomas from their surrounding structures in 4D-CT. These attributes obviate the need for invasively locating parathyroid adenomas preoperatively, thereby enhancing the utilization rate of MIP, which has a favorable implication in the overall clinical outcomes.
DOI: https://doi.org/10.36922/jctr.23.00112
Author affiliation
1Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States of America
2Department of Radiology, The University of Chicago, Chicago, Illinois, United States of America
3School of Medicine, The University of Chicago Medical Center, Chicago, Illinois, United States of America
*Corresponding author:
Daniel T. Ginat
School of Medicine, The University of Chicago Medical Center, Chicago, Illinois, United States of America.
Email: dtg1@uchicago.edu
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