Koji Takumi1, Yoshihiko Fukukura2, Hiroto Hakamada2, Hiroaki Nagano2, Yuichi Kumagae2, Hideo Arima3, Akihiro Nakajo3, Takashi Yoshiura2. 1. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan. takumi@m2.kufm.kagoshima-u.ac.jp. 2. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan. 3. Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan.
Abstract
PURPOSE: To describe CT features of parathyroid carcinomas (PCs) by comparison with benign parathyroid lesions (BPs). METHODS: This retrospective study comprised 82 patients with 76 BPs (62 adenomas and 14 hyperplastic lesions) and 6 PCs. CT features (size, short-to-long axis ratio, shape, peritumoral infiltration, homogeneity, calcification, attenuation values on unenhanced CT, and contrast enhancement during arterial and venous phases) were compared between PCs and BPs. The diagnostic performance of CT features for diagnosing PCs was calculated for these individual parameters. RESULTS: Short-to-long axis ratio was significantly larger in PCs (0.7 ± 0.1) than in BPs (0.5 ± 0.1, p = 0.004). Irregular shape (33%), the presence of peritumoral infiltration (50%), and calcification (33%) were significantly more common in PCs than BPs. The contrast enhancement value was significantly lower in PCs than BPs during arterial (p = 0.004) and venous phases (p = 0.044). The 100% sensitivity criterion for the short-to-long axis ratio (≥ 0.53), enhancement during arterial phase (≤ 56.6HU), and venous phase (≤ 59.5HU) yielded accuracies (62.1%, 71.9%, and 75.4%, respectively). Irregular shape, peritumoral infiltration, and calcification showed high specificity (98.7%) and accuracy (93.9%, 95.1%, and 93.9%, respectively). CONCLUSIONS: CT features of high short-to-long axis ratio, irregular shape, the presence of peritumoral infiltration and calcification, and low contrast enhancement may aid in distinguishing PCs from BPs.
PURPOSE: To describe CT features of parathyroid carcinomas (PCs) by comparison with benign parathyroid lesions (BPs). METHODS: This retrospective study comprised 82 patients with 76 BPs (62 adenomas and 14 hyperplastic lesions) and 6 PCs. CT features (size, short-to-long axis ratio, shape, peritumoral infiltration, homogeneity, calcification, attenuation values on unenhanced CT, and contrast enhancement during arterial and venous phases) were compared between PCs and BPs. The diagnostic performance of CT features for diagnosing PCs was calculated for these individual parameters. RESULTS: Short-to-long axis ratio was significantly larger in PCs (0.7 ± 0.1) than in BPs (0.5 ± 0.1, p = 0.004). Irregular shape (33%), the presence of peritumoral infiltration (50%), and calcification (33%) were significantly more common in PCs than BPs. The contrast enhancement value was significantly lower in PCs than BPs during arterial (p = 0.004) and venous phases (p = 0.044). The 100% sensitivity criterion for the short-to-long axis ratio (≥ 0.53), enhancement during arterial phase (≤ 56.6HU), and venous phase (≤ 59.5HU) yielded accuracies (62.1%, 71.9%, and 75.4%, respectively). Irregular shape, peritumoral infiltration, and calcification showed high specificity (98.7%) and accuracy (93.9%, 95.1%, and 93.9%, respectively). CONCLUSIONS: CT features of high short-to-long axis ratio, irregular shape, the presence of peritumoral infiltration and calcification, and low contrast enhancement may aid in distinguishing PCs from BPs.
Entities:
Keywords:
Helical CT; Imaging, diagnostic; Neck; Parathyroid adenoma; Parathyroid cancer
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