4D-Dynamic contrast-enhanced MRI for preoperative localization in patients with primary hyperparathyroidism

J. L. Becker; V. Patel; K. J. Johnson; M. Guerrero; R. R. Klein; G. F. Ranvier; R. P. Owen; P. Pawha; K. Nael

doi:10.3174/AJNR.A6482

4D-Dynamic contrast-enhanced MRI for preoperative localization in patients with primary hyperparathyroidism

J. L. Becker, V. Patel, K. J. Johnson, M. Guerrero, R. R. Klein, G. F. Ranvier, R. P. Owen, P. Pawha, K. Nael

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

BACKGROUND AND PURPOSE: Our aim was to test the hypothesis that our recently introduced 4D-dynamic contrast-enhanced MR imaging with high spatial and temporal resolution has equivalent accuracy to 4D-CT for preoperative gland localization in primary hyperparathyroidism without requiring exposure to ionizing radiation. MATERIALS AND METHODS: Inclusion criteria were the following: 1) confirmed biochemical diagnosis of primary hyperparathyroidism, 2) preoperative 4D-dynamic contrast-enhanced MR imaging, and 3) surgical cure with>50% decrease in serum parathyroid hormone intraoperatively. 4D-dynamic contrast-enhanced studies were reviewed independently by 2 neuroradiologists to identify the side, quadrant, and number of abnormal glands, and compared with surgical and pathologic results. RESULTS: Fifty-four patients met the inclusion criteria: 37 had single-gland disease, and 17, multigland disease (9 with double-gland hyperplasia; 3 with 3-gland hyperplasia; and 5 with 4-gland hyperplasia). Interobserver agreement (k ) for the side (right versus left) was 0.92 for single-gland disease and 0.70 for multigland disease. Interobserver agreement for the quadrant (superior versus inferior) was 0.70 for single-gland disease and 0.69 for multigland disease. For single-gland disease, the gland was correctly located in 34/37 (92%) patients, with correct identification of the side in 37/37 (100%) and the quadrant in 34/37 (92%) patients. For multigland disease, the glands were correctly located in 35/47 (74%) patients, with correct identification of the side in 35/47 (74%) and the quadrant in 36/47 (77%). CONCLUSIONS: The proposed high spatial and temporal resolution 4D-dynamic contrast-enhanced MR imaging provides excellent diagnostic performance for preoperative localization in primary hyperparathyroidism, with correct gland localization of 92% for single- gland disease and 74% in multigland disease, superior to 4D-CT studies.

Original language	English (US)
Pages (from-to)	522-528
Number of pages	7
Journal	American Journal of Neuroradiology
Volume	41
Issue number	3
DOIs	https://doi.org/10.3174/AJNR.A6482
State	Published - Mar 1 2020

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Clinical Neurology

Access to Document

10.3174/AJNR.A6482

Cite this

@article{456375aeebea45b39aab5c41b18879bb,

title = "4D-Dynamic contrast-enhanced MRI for preoperative localization in patients with primary hyperparathyroidism",

abstract = "BACKGROUND AND PURPOSE: Our aim was to test the hypothesis that our recently introduced 4D-dynamic contrast-enhanced MR imaging with high spatial and temporal resolution has equivalent accuracy to 4D-CT for preoperative gland localization in primary hyperparathyroidism without requiring exposure to ionizing radiation. MATERIALS AND METHODS: Inclusion criteria were the following: 1) confirmed biochemical diagnosis of primary hyperparathyroidism, 2) preoperative 4D-dynamic contrast-enhanced MR imaging, and 3) surgical cure with>50% decrease in serum parathyroid hormone intraoperatively. 4D-dynamic contrast-enhanced studies were reviewed independently by 2 neuroradiologists to identify the side, quadrant, and number of abnormal glands, and compared with surgical and pathologic results. RESULTS: Fifty-four patients met the inclusion criteria: 37 had single-gland disease, and 17, multigland disease (9 with double-gland hyperplasia; 3 with 3-gland hyperplasia; and 5 with 4-gland hyperplasia). Interobserver agreement (k ) for the side (right versus left) was 0.92 for single-gland disease and 0.70 for multigland disease. Interobserver agreement for the quadrant (superior versus inferior) was 0.70 for single-gland disease and 0.69 for multigland disease. For single-gland disease, the gland was correctly located in 34/37 (92%) patients, with correct identification of the side in 37/37 (100%) and the quadrant in 34/37 (92%) patients. For multigland disease, the glands were correctly located in 35/47 (74%) patients, with correct identification of the side in 35/47 (74%) and the quadrant in 36/47 (77%). CONCLUSIONS: The proposed high spatial and temporal resolution 4D-dynamic contrast-enhanced MR imaging provides excellent diagnostic performance for preoperative localization in primary hyperparathyroidism, with correct gland localization of 92% for single- gland disease and 74% in multigland disease, superior to 4D-CT studies.",

author = "Becker, {J. L.} and V. Patel and Johnson, {K. J.} and M. Guerrero and Klein, {R. R.} and Ranvier, {G. F.} and Owen, {R. P.} and P. Pawha and K. Nael",

year = "2020",

month = mar,

day = "1",

doi = "10.3174/AJNR.A6482",

language = "English (US)",

volume = "41",

pages = "522--528",

journal = "American Journal of Neuroradiology",

issn = "0195-6108",

publisher = "American Society of Neuroradiology",

number = "3",

}

TY - JOUR

T1 - 4D-Dynamic contrast-enhanced MRI for preoperative localization in patients with primary hyperparathyroidism

AU - Becker, J. L.

AU - Patel, V.

AU - Johnson, K. J.

AU - Guerrero, M.

AU - Klein, R. R.

AU - Ranvier, G. F.

AU - Owen, R. P.

AU - Pawha, P.

AU - Nael, K.

PY - 2020/3/1

Y1 - 2020/3/1

N2 - BACKGROUND AND PURPOSE: Our aim was to test the hypothesis that our recently introduced 4D-dynamic contrast-enhanced MR imaging with high spatial and temporal resolution has equivalent accuracy to 4D-CT for preoperative gland localization in primary hyperparathyroidism without requiring exposure to ionizing radiation. MATERIALS AND METHODS: Inclusion criteria were the following: 1) confirmed biochemical diagnosis of primary hyperparathyroidism, 2) preoperative 4D-dynamic contrast-enhanced MR imaging, and 3) surgical cure with>50% decrease in serum parathyroid hormone intraoperatively. 4D-dynamic contrast-enhanced studies were reviewed independently by 2 neuroradiologists to identify the side, quadrant, and number of abnormal glands, and compared with surgical and pathologic results. RESULTS: Fifty-four patients met the inclusion criteria: 37 had single-gland disease, and 17, multigland disease (9 with double-gland hyperplasia; 3 with 3-gland hyperplasia; and 5 with 4-gland hyperplasia). Interobserver agreement (k ) for the side (right versus left) was 0.92 for single-gland disease and 0.70 for multigland disease. Interobserver agreement for the quadrant (superior versus inferior) was 0.70 for single-gland disease and 0.69 for multigland disease. For single-gland disease, the gland was correctly located in 34/37 (92%) patients, with correct identification of the side in 37/37 (100%) and the quadrant in 34/37 (92%) patients. For multigland disease, the glands were correctly located in 35/47 (74%) patients, with correct identification of the side in 35/47 (74%) and the quadrant in 36/47 (77%). CONCLUSIONS: The proposed high spatial and temporal resolution 4D-dynamic contrast-enhanced MR imaging provides excellent diagnostic performance for preoperative localization in primary hyperparathyroidism, with correct gland localization of 92% for single- gland disease and 74% in multigland disease, superior to 4D-CT studies.

AB - BACKGROUND AND PURPOSE: Our aim was to test the hypothesis that our recently introduced 4D-dynamic contrast-enhanced MR imaging with high spatial and temporal resolution has equivalent accuracy to 4D-CT for preoperative gland localization in primary hyperparathyroidism without requiring exposure to ionizing radiation. MATERIALS AND METHODS: Inclusion criteria were the following: 1) confirmed biochemical diagnosis of primary hyperparathyroidism, 2) preoperative 4D-dynamic contrast-enhanced MR imaging, and 3) surgical cure with>50% decrease in serum parathyroid hormone intraoperatively. 4D-dynamic contrast-enhanced studies were reviewed independently by 2 neuroradiologists to identify the side, quadrant, and number of abnormal glands, and compared with surgical and pathologic results. RESULTS: Fifty-four patients met the inclusion criteria: 37 had single-gland disease, and 17, multigland disease (9 with double-gland hyperplasia; 3 with 3-gland hyperplasia; and 5 with 4-gland hyperplasia). Interobserver agreement (k ) for the side (right versus left) was 0.92 for single-gland disease and 0.70 for multigland disease. Interobserver agreement for the quadrant (superior versus inferior) was 0.70 for single-gland disease and 0.69 for multigland disease. For single-gland disease, the gland was correctly located in 34/37 (92%) patients, with correct identification of the side in 37/37 (100%) and the quadrant in 34/37 (92%) patients. For multigland disease, the glands were correctly located in 35/47 (74%) patients, with correct identification of the side in 35/47 (74%) and the quadrant in 36/47 (77%). CONCLUSIONS: The proposed high spatial and temporal resolution 4D-dynamic contrast-enhanced MR imaging provides excellent diagnostic performance for preoperative localization in primary hyperparathyroidism, with correct gland localization of 92% for single- gland disease and 74% in multigland disease, superior to 4D-CT studies.

UR - http://www.scopus.com/inward/record.url?scp=85082093330&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85082093330&partnerID=8YFLogxK

U2 - 10.3174/AJNR.A6482

DO - 10.3174/AJNR.A6482

M3 - Article

C2 - 32165367

SN - 0195-6108

VL - 41

SP - 522

EP - 528

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

IS - 3

ER -

4D-Dynamic contrast-enhanced MRI for preoperative localization in patients with primary hyperparathyroidism

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this