1. Detection and localization of hyperfunctioning parathyroid glands on [18F]fluorocholine PET/CT using deep learning – model performance and comparison to human expertsLeon Jarabek, Jan Jamšek, Anka Cuderman, Sebastijan Rep, Marko Hočevar, Tomaž Kocjan, Mojca Jensterle Sever, Žiga Špiclin, Žiga Maček Ležaić, Filip Cvetko, Luka Ležaič, 2022, izvirni znanstveni članek Povzetek: In the setting of primary hyperparathyroidism (PHPT), [18F]fluorocholine PET/CT (FCH-PET) has excellent diagnostic performance, with experienced practitioners achieving 97.7% accuracy in localising hyperfunctioning parathyroid tissue (HPTT). Due to the relative triviality of the task for human readers, we explored the performance of deep learning (DL) methods for HPTT detection and localisation on FCH-PET images in the setting of PHPT. Patients and methods. We used a dataset of 93 subjects with PHPT imaged using FCH-PET, of which 74 subjects had visible HPTT while 19 controls had no visible HPTT on FCH-PET. A conventional Resnet10 as well as a novel mPETResnet10 DL model were trained and tested to detect (present, not present) and localise (upper left, lower left, upper right or lower right) HPTT. Our mPETResnet10 architecture also contained a region-of-interest masking algorithm that we evaluated qualitatively in order to try to explain the model’s decision process. Results. The models detected the presence of HPTT with an accuracy of 83% and determined the quadrant of HPTT with an accuracy of 74%. The DL methods performed statistically worse (p < 0.001) in both tasks compared to human readers, who localise HPTT with the accuracy of 97.7%. The produced region-of-interest mask, while not showing a consistent added value in the qualitative evaluation of model’s decision process, had correctly identified the foreground PET signal. Conclusions. Our experiment is the first reported use of DL analysis of FCH-PET in PHPT. We have shown that it is possible to utilize DL methods with FCH-PET to detect and localize HPTT. Given our small dataset of 93 subjects, results are nevertheless promising for further research
Ključne besede: primary hyperparathyroidism, deep learning, nuclear medicine
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2. Adrenal vein sampling for primary aldosteronism : a 15-year national referral center experienceTomaž Kocjan, Mojca Jensterle Sever, Gaj Vidmar, Rok Vrčkovnik, Pavel Berden, Milenko Stankovič, 2020, izvirni znanstveni članek Povzetek: Background Adrenal vein sampling (AVS) is essential for diagnostics of primary aldosteronism, distinguishing unilateral from bilateral disease and determining treatment options. We reviewed the performance of AVS for primary aldosteronism at our center during first 15 years, comparing the initial period to the period after the introduction of a dedicated radiologist. Additionally, AVS outcomes were checked against CT findings and the proportion of operated patients with proven unilateral disease was estimated. Patients and methods A retrospective cross-sectional study conducted at the national endocrine referral center included all patients with primary aldosteronism who underwent AVS after its introduction in 2004 until the end of 2018. AVS was performed sequentially during Synacthen infusion. When the ratio of cortisol concentrations from adrenal vein and inferior vena cava was at least 5, AVS was considered successful. Results Data from 235 patients were examined (168 men; age 32%73, median 56 years; BMI 18%48, median 30.4 kg/ m2). Average number of annual AVS procedures increased from 7 in the 2004%2011 period to 29 in the 2012%2018 period (p < 0.001). AVS had to be repeated in 10% of procedures; it was successful in 77% of procedures and 86% of patients. The proportion of patients with successful AVS (92% in 2012%2018 vs. 66% in 2004%2011, p < 0.001) and of successful AVS procedures (82% vs. 61%, p < 0.001) was statistically significantly higher in the recent period. Conclusions Number of AVS procedures and success rate at our center increased over time. Introduction of a dedicated radiologist and technical advance expanded and improved the AVS practice.
Ključne besede: angiography, adrenal gland, endocrine disorders
Objavljeno v DiRROS: 15.07.2024; Ogledov: 137; Prenosov: 76
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3. Optimal scan time for evaluation of parathyroid adenoma with [18F]-fluorocholine PET/CTSebastijan Rep, Luka Ležaič, Tomaž Kocjan, Marija Pfeifer, Mojca Jensterle Sever, Urban Simončič, Petra Tomše, Marko Hočevar, 2015, izvirni znanstveni članek Ključne besede: lesions representing enlarged parathyroid tissue, triple-phase, standardized uptake value, retention index, lesion contrast, rak (medicina), obščitnični adenomi, diagnostika
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4. Klinična pot primarni hiperparatiroidizemKlara Širca, Tomaž Kocjan, Marko Hočevar, 2022, slovar, enciklopedija, leksikon, priročnik, atlas, zemljevid Ključne besede: onkologija, imunoterapija, neželeni učinki
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5. Addisonska kriza pri bolnici z neprepoznanim panhipopituitarizmom po obsevanju atipičnega meningeomaTomaž Kocjan, Lorna Zadravec-Zaletel, Berta Jereb, 2011, drugi znanstveni članki Povzetek: Obsevanje je utečen in uspešen način zdravljenja možganskih tumorjev, vendar moramo vedeti, da ima poleg akutnih neželenih učinkov lahko tudi pozne posledice, ki se pokažejo šele leta po končanem zdravljenju. Med največkrat na ta način okvarjenimi organi so endokrine žleze, predvsem hipotalamus in hipofiza. Na podlagi kliničnega primera želimo pokazati, da bolniki po obsevanju glave nujno potrebujejo tudi redno endokrinološko testiranje in po potrebi ustrezno hormonsko nadomestno zdravljenje.
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