Page 71 - JCTR-10-2

Journal of Clinical and Translational Research 2024; 10(2): 165-171

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

ORIGINAL ARTICLE

Utilizing radiomic features of arterial phase computed tomography for

delineating parathyroid adenomas from surrounding anatomical structures

Chime Ezenekwe , Michael H. Zhang , Irfan Hussain , Daniel T. Ginat *
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1
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1 Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States of America, Department of Radiology, The University of
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Chicago, Chicago, Illinois, United States of America, School of Medicine, The University of Chicago Medical Center, Chicago, Illinois, United States
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of America
ARTICLE INFO ABSTRACT
Article history: Aim: The study aimed to correlate radiomic data of four-dimensional computed tomography (4D-CT)
Received: September 18, 2023 with pathology-proven parathyroid adenomas to identify and quantitate select dimensional and
Accepted: November 7, 2023 textural features that predict parathyroid adenomas with a high degree of confidence, with the ultimate
Published Online: April 25, 2024 goal of improving the reliability of parathyroid adenoma detection so as to facilitate the subsequent
unilateral minimally invasive parathyroidectomy (MIP).
Keywords: Methods: A total of 144 subjects with a history of neck 4D-CT, parathyroidectomy, and intraoperative
Parathyroid adenoma pathology-proven parathyroid adenoma(s) were retrospectively reviewed. Following the exclusion of
Radiomics patients with a thyroidectomy, unsuccessful surgery, or indeterminate localization of the parathyroid
Texture analysis adenoma on 4D-CT, a preliminary sample of 20 patients was obtained. Four anatomical structures
Imaging (carotid artery, internal jugular vein, thyroid, and parathyroid adenoma) were segmented twice on
Four-dimensional computed tomography 25-second arterial phase axial sections of a 4D-CT, and radiomic data of the shape, first-order, and
Radiology 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
*Corresponding author: exhibited overall significant differences when compared to the parathyroid adenoma data (P < 0.05).
Daniel T. Ginat Further Tukey’s post hoc analysis revealed that, when the parathyroid adenoma group was treated
School of Medicine, The University of Chicago as the reference, 11/16 shape class, 16/18 first-order class, and 46/69 second-order class variables
Medical Center, Chicago, Illinois, United States significantly differ from the carotid artery, jugular vein, and/or thyroid group(s). In addition, we found
of America. that the thyroid has distinct textural features compared to the parathyroid group, with 1/18 first-order
Email: dtg1@uchicago.edu 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,
© 2024 Author(s). This is an Open-Access and busyness exhibited the highest level of differences between the two groups (P < 0.0001).
article distributed under the terms of the Conclusion: The parathyroid adenoma group is associated with a unique set of radiomic variables
Creative Commons Attribution-Noncommercial in comparison to surrounding anatomy such as the carotid artery, internal jugular vein, and thyroid.
License, permitting all non-commercial use,
distribution, and reproduction in any medium, Relevance for Patients: The distinct, quantifiable differences in dimensional and textural features
provided the original work is properly cited. 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.

1. Introduction

Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by blood
serum parathyroid hormone (PTH) levels >8 pmol/L and/or a serum calcium level higher
than 2.60 mmol/L [1] caused by one or more of the parathyroid glands secreting an excess
amount of PTH. The majority of cases are induced by a single parathyroid adenoma (89%)
DOI: https://doi.org/10.36922/jctr.23.00112