Eun Kyoung Lee1,2, Tae Jin Yun3,4, Ji-Hoon Kim1,5, Kyu Eun Lee6, Su-Jin Kim6, Jae-Kyung Won7, Koung Mi Kang1,5, Seung Hong Choi1,5, Chul-Ho Sohn1,5. 1. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. 2. Department of Radiology, Dongguk University Ilsan Hospital, Goyang-si, Republic of Korea. 3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. radiologyyun@gmail.com. 4. Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea. radiologyyun@gmail.com. 5. Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea. 6. Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea. 7. Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea.
Abstract
INTRODUCTION: The purpose of this study is to assess the effect of tumor volume on the enhancement pattern of parathyroid adenoma (PTA) on four-dimensional computed tomography (4D-CT). METHODS: We analyzed the enhancement patterns of PTA on four-phase 4D-CT in 44 patients. Dependency of the changes of Hounsfield unit values (ΔHU) on the tumor volumes and clinical characteristics was evaluated using linear regression analyses. In addition, an unpaired t test was used to compare ΔHU of PTAs between PTA volume ≥1 cm(3) and <1 cm(3), thyroid gland, and lymph node. RESULTS: PTA volume based on CT was the strongest factor on the ΔHUPre to Arterial and ΔHUArterial to Venous and ΔHUArterial to Delayed (R (2) = 0.34, 0.25, and 0.32, respectively, P < 0.001 for both). PTA ≥1 cm(3) had statistically significant greater enhancement between the unenhanced phase and the arterial phase than PTA <1 cm(3) (mean values ± standard deviations (SDs) of ΔHUPre to Arterial, 102.7 ± 33.7 and 57.5 ± 28.8, respectively, P < 0.001). PTA ≥1 cm(3) showed an early washout pattern on the venous phase, whereas PTA <1 cm(3) showed a progressive enhancement pattern on the venous phase (mean values ± SDs of ΔHUArterial to Venous, -13.2 ± 31.6 and 14.4 ± 32.7, respectively; P = 0.009). CONCLUSION: The enhancement pattern of PTA on 4D-CT is variable with respect to PTA volume based on CT. Therefore, the enhancement pattern of PTA on 4D-CT requires careful interpretation concerning the tumor volume, especially in cases of PTA <1 cm(3).
INTRODUCTION: The purpose of this study is to assess the effect of tumor volume on the enhancement pattern of parathyroid adenoma (PTA) on four-dimensional computed tomography (4D-CT). METHODS: We analyzed the enhancement patterns of PTA on four-phase 4D-CT in 44 patients. Dependency of the changes of Hounsfield unit values (ΔHU) on the tumor volumes and clinical characteristics was evaluated using linear regression analyses. In addition, an unpaired t test was used to compare ΔHU of PTAs between PTA volume ≥1 cm(3) and <1 cm(3), thyroid gland, and lymph node. RESULTS: PTA volume based on CT was the strongest factor on the ΔHUPre to Arterial and ΔHUArterial to Venous and ΔHUArterial to Delayed (R (2) = 0.34, 0.25, and 0.32, respectively, P < 0.001 for both). PTA ≥1 cm(3) had statistically significant greater enhancement between the unenhanced phase and the arterial phase than PTA <1 cm(3) (mean values ± standard deviations (SDs) of ΔHUPre to Arterial, 102.7 ± 33.7 and 57.5 ± 28.8, respectively, P < 0.001). PTA ≥1 cm(3) showed an early washout pattern on the venous phase, whereas PTA <1 cm(3) showed a progressive enhancement pattern on the venous phase (mean values ± SDs of ΔHUArterial to Venous, -13.2 ± 31.6 and 14.4 ± 32.7, respectively; P = 0.009). CONCLUSION: The enhancement pattern of PTA on 4D-CT is variable with respect to PTA volume based on CT. Therefore, the enhancement pattern of PTA on 4D-CT requires careful interpretation concerning the tumor volume, especially in cases of PTA <1 cm(3).
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