Academic Radiology最新文献

{"title":"Enhancing Radiologists’ Performance in Detecting Cerebral Aneurysms Using a Deep Learning Model: A Multicenter Study","authors":"Liyong Zhuo ,&nbsp;Yu Zhang ,&nbsp;Zijun Song ,&nbsp;Zhanhao Mo ,&nbsp;Lihong Xing ,&nbsp;Fengying Zhu ,&nbsp;Huan Meng ,&nbsp;Lei Chen ,&nbsp;Guoxiang Qu ,&nbsp;Pengbo Jiang ,&nbsp;Qian Wang ,&nbsp;Ruonan Cheng ,&nbsp;Xiaoming Mi ,&nbsp;Lin Liu ,&nbsp;Nan Hong ,&nbsp;Xiaohuan Cao ,&nbsp;Dijia Wu ,&nbsp;Jianing Wang PhD ,&nbsp;Xiaoping Yin","doi":"10.1016/j.acra.2024.09.038","DOIUrl":"10.1016/j.acra.2024.09.038","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>This study aimed to develop a deep learning (DL)-based model for detecting and diagnosing cerebral aneurysms in clinical settings, with and without human assistance.</div></div><div><h3>Materials and Methods</h3><div>The DL model was trained using data from 3829 patients across 11 clinical centers and tested on 484 patients from three institutions. Image interpretations were conducted by 10 radiologists (four junior, six senior), the DL model alone, and a combination of radiologists with the DL model. Time spent on post-processing and reading was recorded. The analysis of the area under the curve (AUC), sensitivity, and specificity for the above-mentioned three reading modes was performed at both the lesion and patient levels.</div></div><div><h3>Results</h3><div>Combining the DL model with radiologists reduced image interpretation time by 37.2% and post-processing time by 90.8%. With DL model assistance, the AUC increased from 0.842 to 0.881 (<em>P</em> = 0.008) for junior radiologists (JRs) and from 0.853 to 0.895 (<em>P</em> &lt; 0.001) for senior radiologists (SRs). With DL model assistance, sensitivity significantly improved at both lesion (JR: 68.9% to 81.6%, <em>P</em> = 0.011; SR: 72.4% to 83.5%, <em>P</em> &lt; 0.001) and patient levels (JR: 76.2% to 86.9%, <em>P</em> = 0.011; SR: 80.1% to 88.2%, <em>P</em> &lt; 0.001). Specificity at the patient level showed improvement (JR: 82.6% to 82.7%, P = 0.005; SR: 82.6% to 86.1%, <em>P</em> = 0.<em>021</em>).</div></div><div><h3>Conclusions</h3><div>The DL model enhanced radiologists’ diagnostic performance in detecting cerebral aneurysms, especially for JRs, and expedited the workflow.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1611-1620"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram to Predict Tumor Remnant of Small Hepatocellular Carcinoma after Microwave Ablation","authors":"Chenyang Qiu,&nbsp;Yinchao Ma,&nbsp;Mengjun Xiao,&nbsp;Zhipeng Wang,&nbsp;Shuzhen Wu,&nbsp;Kun Han,&nbsp;Haiyan Wang","doi":"10.1016/j.acra.2024.09.066","DOIUrl":"10.1016/j.acra.2024.09.066","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>This investigation sought to create a nomogram to predict the ablation effect after microwave ablation in patients with hepatocellular carcinoma, which can guide the selection of microwave ablation for small hepatocellular carcinomas.</div></div><div><h3>Methods</h3><div>In this two-center retrospective study, 233 patients with hepatocellular carcinoma treated with microwave ablation (MWA) between January 2016 and December 2023 were enrolled and analyzed for their clinical baseline data, laboratory parameters, and MR imaging characteristics. Logistic regression analysis was used to screen the features, and clinical and imaging feature models were developed separately. Finally, a nomogram was established. All models were evaluated using the area under the curve (AUC), accuracy, sensitivity, specificity, and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>Two models and a nomogram were developed to predict ablation outcomes after MWA based on a training set (n = 182, including complete ablation: 136, incomplete ablation: 46) and an external validation set (n = 51, complete ablation: 36, incomplete ablation: 15). The clinical models and nomogram performed well in the external validation cohort. The AUC of the nomogram was 0.966 (95% CI: 0.944- 0.989), with a sensitivity of 0.935, a specificity of 0.882, and an accuracy of 0.896.</div></div><div><h3>Conclusions</h3><div>Combining clinical data and imaging features, a nomogram was constructed that could effectively predict the postoperative ablation outcome in hepatocellular carcinoma patients undergoing MWA, which could help clinicians provide treatment options for hepatocellular carcinoma patients.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1419-1430"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple Rule Out CT in the Emergency Department: Clinical Risk and Outcomes (Triple Rule Out in the Emergency Department)","authors":"Philip A. Araoz M.D. ,&nbsp;Srikanth Gadam M.B.B.S. ,&nbsp;Aditi K. Bhanushali M.B.B.S. ,&nbsp;Palak Sharma M.B.B.S. ,&nbsp;Mansunderbir Singh M.B.B.S ,&nbsp;Aidan F. Mullan M.A. ,&nbsp;Jeremy D. Collins M.D. ,&nbsp;Phillip M. Young M.D. ,&nbsp;Stephen Kopecky M.D. ,&nbsp;Casey M. Clements M.D., Ph.D.","doi":"10.1016/j.acra.2024.10.051","DOIUrl":"10.1016/j.acra.2024.10.051","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Triple rule out CT protocols (TRO-CT) have been advocated as a single test to simultaneously evaluate major causes of acute chest pain, in particular acute myocardial infarction (MI), acute pulmonary embolism (PE), and acute aortic syndrome. However, it is unclear what patient populations would benefit from a such comprehensive exam and current guidelines recommend tailoring CT protocols to the most likely diagnosis.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed TRO-CT scans performed from the Emergency Department (ED) at our institution from April 2021 to April 2022. Charts were reviewed to calculate clinical risk of MI, PE, and acute aortic syndrome using conventional clinical scoring systems (HEART score, PERC score, ADD-RS). TRO-CT findings and 30-day clinical outcomes were recorded from chart review.</div></div><div><h3>Results</h3><div>1279 patients ED patients scanned with TRO-CT were included in the analysis. 831 patients (65.0%) were at-risk for two or more clinical risk scores. At TRO-CT, 381 (29.8%) patients had obstructive CAD. 91 (7.1%) had acute PE. 7 (0.5%) had acute aortic syndrome. At 30-day clinical follow up, 28 patients (2.2%) had the diagnosis of acute MI (95% CI: 1.5–3.2%). 90 patients (7.0%) had the diagnosis of acute PE (95% CI: 5.7–8.6%). 7 patients (0.5%) had the diagnosis acute aortic syndrome (95% CI: 0.2–1.2%). A low-risk HEART score was associated with a 0.3% 30-day clinical diagnosis of acute MI (95% CI: 0.0–1.6%). Low-risk-PERC was associated with a 2.9% 30-day clinical diagnosis of acute PE (95% CI: 0.7–8.7%). Low-risk ADD-RS was associated with a 0.3% 30-day clinical diagnosis of acute aortic syndrome (95% CI: 0.0–1.8%).</div></div><div><h3>Conclusions</h3><div>We found a high clinical overlap in the presentation of acute MI, acute PE, and acute aortic syndrome based on clinical risk scores. Further studies will be needed to compare a TRO-CT algorithm to a standard-of-care algorithm in patients presenting to the ED.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1297-1305"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Efficacy of Ventilation-Perfusion Single Photo Emission Computed Tomography/Computed Tomography for Pulmonary Hypertension due to Fibrinous Mediastinitis","authors":"Hui-Ting Li ,&nbsp;Feng-Xian Zhang ,&nbsp;Su-Gang Gong ,&nbsp;Qin-Hua Zhao ,&nbsp;Ci-Jun Luo ,&nbsp;Hong-Ling Qiu ,&nbsp;Jing He ,&nbsp;Jin-Ming Liu ,&nbsp;Lan Wang PhD ,&nbsp;Yang-Chun Chen PhD","doi":"10.1016/j.acra.2024.11.026","DOIUrl":"10.1016/j.acra.2024.11.026","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Comprehensive data on the use of ventilation-perfusion single-photo emission computed tomography/computed tomography (V/Q SPECT/CT), an established diagnostic tool for chronic thromboembolic pulmonary hypertension, in identifying pulmonary hypertension secondary to fibrinous mediastinitis (PH-FM) is scarce. This study aimed to assess its diagnostic efficacy for PH-FM.</div></div><div><h3>Materials and Methods</h3><div>Patients with PH due to pulmonary artery stenosis were assessed using V/Q SPECT/CT, computed tomography pulmonary angiography (CTPA), and digital subtraction pulmonary angiography (PAG). Abnormal mediastinal or hilar features identified by V/Q SPECT/CT, correlating with perfusion defects, were used to diagnose PH-FM. Final clinical diagnosis is recognized as the gold standard for this study. Diagnostic accuracy was compared using receiver operating characteristic (ROC) analysis and Cohen's kappa coefficient to evaluate agreement among the imaging methods.</div></div><div><h3>Results</h3><div>Among the patients included, 21 had PH-FM, and 76 had PH associated with non-FM. V/Q SPECT/CT showed higher sensitivity (90%), specificity (95%), and accuracy (94%) for detecting PH-FM compared to CTPA (sensitivity 86%, specificity 92%, accuracy 91%) and PAG (sensitivity 62%, specificity 87%, accuracy 81%). The areas under the ROC curve for V/Q SPECT/CT, CTPA, and PAG were 0.93, 0.89, and 0.74, respectively. V/Q SPECT/CT achieved better agreement with the gold standard than CTPA or PAG (κ<!--> <!-->=<!--> <!-->0.82, κ<!--> <!-->=<!--> <!-->0.69 and κ<!--> <!-->=<!--> <!-->0.49, respectively).</div></div><div><h3>Conclusion</h3><div>V/Q SPECT/CT demonstrates superior diagnostic efficacy and accuracy compared to CTPA and PAG in diagnosing PH-FM.</div></div><div><h3>Clinical Relevance Statement</h3><div>Compared to computed tomography pulmonary angiography and digital subtraction pulmonary angiography, ventilation-perfusion single-photo emission computed tomography/computed tomography demonstrates superior diagnostic efficiency for pulmonary hypertension secondary to fibrinous mediastinitis, leading to improved early detection and accuracy, thus optimizing diagnostic pathways.</div></div><div><h3>Key Points</h3><div><ul><li><span></span><span><div>1. Data on ventilation-perfusion single-photo emission computed tomography/computed tomography (V/Q SPECT/CT) demonstrates superior diagnostic efficiency for pulmonary hypertension secondary to fibrinous mediastinitis (PH-FM) was limited.</div></span></li><li><span></span><span><div>2. V/Q SPECT/CT exhibits perfect diagnostic accuracy in identifying PH-FM from chronic pulmonary vascular stenosis diseases.</div></span></li><li><span></span><span><div>3. V/Q SPECT/CT can early and accurately diagnose PH-FM, thus optimizing diagnostic pathways.</div></span></li></ul></div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1725-1733"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Radiology Reporting and the Peer Review Process.","authors":"Eniola T Oluyemi, Jeffrey P Guenette, Tessa S Cook, Jeffrey G Jarvik","doi":"10.1016/j.acra.2025.02.036","DOIUrl":"https://doi.org/10.1016/j.acra.2025.02.036","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of Deep Learning Grad-CAM and Radiomics for Automatic Localization and Diagnosis of Architectural Distortion on DBT","authors":"Xiao Chen ,&nbsp;Yang Zhang ,&nbsp;Jiejie Zhou ,&nbsp;Yong Pan ,&nbsp;Hanghui Xu ,&nbsp;Ying Shen ,&nbsp;Guoquan Cao ,&nbsp;Min-Ying Su ,&nbsp;Meihao Wang","doi":"10.1016/j.acra.2024.10.031","DOIUrl":"10.1016/j.acra.2024.10.031","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Detection and diagnosis of architectural distortion (AD) on digital breast tomosynthesis (DBT) is challenging. This study applied artificial intelligence (AI) using deep learning (DL) algorithms to detect AD, followed by radiomics for classification.</div></div><div><h3>Materials and Methods</h3><div>500 cases with AD on DBT reports were identified; the earlier 292 cases for training, and the later 208 cases for testing. The DL Gradient-weighted Class Activation Mapping (Grad-CAM) was applied to automatically localize abnormalities and generate a region of interest (ROI), which was put into the radiomics model to estimate the malignancy probability for constructing ROC curves. Radiologists delineated ROI manually for comparison. Cases were categorized into pure AD and AD associated with other features, including mass, regional high-density, and calcifications. The ROC curves were compared using the DeLong test.</div></div><div><h3>Results</h3><div>The overall malignancy rate was 57% (285/500). Of them, 267 cases were classified as pure AD, and the malignancy rate (106/267 = 39.7%) was significantly lower compared to AD cases associated with other features (179/233 = 76.8%, <em>p</em> &lt; 0.01). In the testing set, the diagnostic AUC was 0.82 when using the manual ROI and 0.84 when using the DL-generated ROI. In the more challenging pure AD cases, DL-generated ROI yielded an AUC of 0.77, significantly lower than 0.86 for AD associated with other features.</div></div><div><h3>Conclusion</h3><div>DL could detect AD on DBT, and the diagnostic performance was comparable to manual ROI. The strategy worked for pure AD, but the performance was worse than that for AD with other features.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1287-1296"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central Executive Network Dysfunction Could Potentially Play a Crucial Role in the Development of Mild Cognitive Impairment in Patients with End-Stage Renal Disease","authors":"Zhiping Zhang,&nbsp;Fei Chen","doi":"10.1016/j.acra.2024.12.044","DOIUrl":"10.1016/j.acra.2024.12.044","url":null,"abstract":"","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1598-1600"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Trends in Remote and Flexible Work Options in Radiology and Perception of Impact on Radiologist Well-being","authors":"Lily M. Belfi MD ,&nbsp;Michele Retrouvey MD ,&nbsp;L. Alexandre Frigini MD ,&nbsp;Samantha Harrington MD ,&nbsp;Zoe Verzani MPH ,&nbsp;Ryan Woods MD, MPH ,&nbsp;Sarah L. Averill MD","doi":"10.1016/j.acra.2024.11.071","DOIUrl":"10.1016/j.acra.2024.11.071","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to assess the current trends in remote and flexible work models in radiology, evaluate their perceived impact on radiologists' well-being, and explore the importance of these options in shaping employment decisions.</div></div><div><h3>Methods</h3><div>A voluntary, anonymous survey was sent to 981 members of the Association of Academic Radiologists (AAR) in April 2024. Descriptive statistics were used to analyze demographics and trends in remote and flexible work participation. Statistical tests, including chi-square and Fisher’s exact test, were employed to assess differences in perceptions based on gender and career stage. Responses from openended questions were analyzed to identify common themes and solutions related to remote and flexible work.</div></div><div><h3>Results</h3><div>A total of 205 respondents answered the survey resulting in a response rate of 20.9%. 91.8% of respondents reported that their institution offered remote work options, with 73% participating in remote work. The top benefits included improved work-life balance, flexibility, and reduced commute time. Hybrid work models were preferred by 79% of respondents, and 89% of those participating in remote work reported increased well-being. Flexible scheduling was offered to 46.4% of respondents, with 91% reporting an increase in well-being from these options. Remote and flexible work options were viewed as important in employment decisions by 68–70% of respondents. Gender and career stage: Significant differences emerged in the perceived benefits of remote and flexible work, with female radiologists and early- to mid-career radiologists reporting greater benefits related to work-life balance and caregiving responsibilities.</div></div><div><h3>Conclusion</h3><div>Remote and flexible work models in radiology are increasingly available and positively impact radiologists' well-being and job satisfaction. The study highlights the importance of these options, especially for early-career and female radiologists. Addressing the challenges of remote work can further optimize these work models, promoting retention, diversity, and workforce sustainability in radiology.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1661-1670"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Industry and Environmental Sustainability: Radiology’s Next Biggest Opportunity for Meaningful Change","authors":"Lena Khanolkar BA ,&nbsp;John R. Scheel MD, PhD, MPH","doi":"10.1016/j.acra.2024.12.033","DOIUrl":"10.1016/j.acra.2024.12.033","url":null,"abstract":"<div><div>Climate change has widespread impacts on patient health, affecting most body organs. At the same time, healthcare systems are a large contributor to global greenhouse emissions and other environmental harms, yet very few such organizations have taken concrete steps to encourage sustainable practices. Radiology should drive sustainable change because we are one of the most energy intensive and one of the fastest growing specialties within healthcare. While most current efforts focus on decreasing carbon emissions and other impacts of individual modalities, radiologists ought to broaden their perspectives. Incentives and education for trainees and clinicians to reduce unnecessary imaging is paramount to decrease radiology’s environmental impact. A three-pronged approach guides change: increasing sustainability of essential studies, leveraging education to decrease low-value imaging, and expanding equitable access to preventative (high-value) imaging services. If radiology takes the lead, other specialties may follow.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1671-1674"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental detection of parathyroid adenomas on chest CT before clinical presentation of hyperparathyroidism","authors":"Raquelle El Alam ,&nbsp;Mark M. Hammer ,&nbsp;Rachna Madan","doi":"10.1016/j.acra.2024.09.031","DOIUrl":"10.1016/j.acra.2024.09.031","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>To evaluate whether parathyroid adenomas can be detected by thoracic radiologists on routine chest CT.</div></div><div><h3>Materials/Methods</h3><div>This retrospective study included patients with hyperparathyroidism evaluated by parathyroid scans and a control group with normal calcium. All had enhanced chest CT within 36 months prior to parathyroid imaging. Chest CTs were reviewed by 3 blinded thoracic radiologists. We report diagnostic accuracy for all positive findings and findings &gt; 8 mm.</div></div><div><h3>Results</h3><div>Our sample comprised 126 patients, 63 with confirmed hyperparathyroidism and 63 control patients; 6 parathyroid cases were excluded for being out of the field of view. Readers 1, 2, and 3 had sensitivity of 95%, 60%, and 35%, and specificity of 88%, 89%, and 97%, respectively. Specificity increased to 95%, 97%, and 98% when considering only findings larger than 8 mm. Review of false negative studies for reader 1 revealed 3 parathyroid adenomas visualized in retrospect. Review of the 7 false positive studies for reader 1 revealed candidate lesions in all of them attributed to exophytic thyroid nodules or lymph nodes. 90%, 67%, and 40% of the parathyroid adenoma patients had at least 1, 2, and 3 complications respectively. Most prevalent complications were nephrolithiasis (48%) and osteopenia (46%).</div></div><div><h3>Conclusions</h3><div>Routine contrast-enhanced chest CT can detect the majority of parathyroid adenomas with high specificity.</div></div><div><h3>Clinical Relevance/Application</h3><div>Increasing awareness of parathyroid adenomas by chest radiologists allow for detection of enlarged parathyroid glands, diagnosing hyperparathyroidism before clinical presentation.</div></div>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":"32 3","pages":"Pages 1353-1359"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}