Document Detail

Imaging characteristics of hyperfunctioning parathyroid adenomas using multiphase multidectector computed tomography: a quantitative and qualitative approach.
MedLine Citation:
PMID:  21926850     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective of the study was to characterize the enhancement pattern of hyperfunctioning parathyroid adenomas on multiphase multidetector computed tomography (CT) or 4-dimensional CT.
METHODS: We retrospectively studied the enhancement patterns of 48 pathologically confirmed parathyroid adenomas with 4-dimensional CT, compliant with institutional review and the Health Insurance Portability and Accountability Act. Region-of-interest analysis was done at baseline and at arterial (25 seconds), venous (55 seconds), and delayed (85 seconds) enhancement phases over the adenoma and adjacent normal thyroid tissue. Qualitative and quantitative analysis was done. Discriminant functions were calculated using a multivariate logistic regression model, and receiver operating characteristic curves were measured.
RESULTS: Adenomas are lower than thyroid in density, demonstrate avid early contrast enhancement, and show rapid wash-out of contrast. Adenomas and thyroid had baseline Hounsfield unit attenuations of 35 ± 11 and 94 ± 21 and enhancement percentage change from baseline to arterial of 493% ± 328% and 132% ± 148%, respectively (P < 0.0001 both). Quantitative analysis showed that these 2 measures of baseline density and the percentage change from baseline to arterial were the most powerful discriminatory features, with contrast wash-out from arterial peak to venous phase being a less powerful discriminator. Several discriminant functions were derived, the best of which was: X = 13.74 - (0.207 × baseline Hounsfield unit) - (0.006 × percent density change from baseline to arterial). X > 0.2 classifies tissue as parathyroid with high certainty (area under the receiver operating characteristic curve = 0.98; specificity, 0.938; sensitivity, 0.999).
CONCLUSIONS: Parathyroid adenomas have a characteristic enhancement pattern that can be distinguished from thyroid tissue: the key diagnostic discriminators are baseline density, percentage change in density from baseline to arterial enhancement, and percentage decrease in density from arterial to venous phases.
Thinh H Vu; Nandita Guha-Thakurta; Robyn K Harrell; Salmaan Ahmed; Ashok J Kumar; Valen E Johnson; Nancy D Perrier; Leena M Hamberg; George J Hunter; Dawid Schellingerhout
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of computer assisted tomography     Volume:  35     ISSN:  1532-3145     ISO Abbreviation:  J Comput Assist Tomogr     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-09-19     Completed Date:  2011-12-05     Revised Date:  2014-06-06    
Medline Journal Info:
Nlm Unique ID:  7703942     Medline TA:  J Comput Assist Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  560-7     Citation Subset:  IM    
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MeSH Terms
Adenoma / radiography*
Aged, 80 and over
Contrast Media / diagnostic use
Logistic Models
Middle Aged
Parathyroid Neoplasms / radiography*
ROC Curve
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Statistics, Nonparametric
Tomography, X-Ray Computed / methods*
Triiodobenzoic Acids / diagnostic use
Grant Support
Reg. No./Substance:
0/Contrast Media; 0/Triiodobenzoic Acids; 87771-40-2/ioversol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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