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Three-Phase Parathyroid 4-Dimensional Computed Tomography Initial Experience: Inexperienced Readers Have High Accuracy and High Interobserver Agreement

Sepahdari, Ali R. MD; Yeh, Michael W. MD; Rodrigues, David MD; Khan, Sarah N. MD; Harari, Avital MD

Journal of Computer Assisted Tomography: July/August 2013 - Volume 37 - Issue 4 - p 511–517
doi: 10.1097/RCT.0b013e31828beb34

Objective Multiphase multidetector contrast-enhanced parathyroid CT (4-dimensional computed tomography [4D-CT]) is an emerging tool for evaluating patients with primary hyperparathyroidism. Our goal was to describe the initial performance of 2 inexperienced readers in interpretation of 4D-CT.

Methods Twenty-three subjects who received 4D-CT and successful surgical exploration were studied (14 initial and 9 repeat explorations; 15 single-gland disease and 8 multigland disease) A staff neuroradiologist prospectively interpreted all studies, and a neuroradiology fellow retrospectively interpreted all studies; their results were compared with the surgical findings for each side of the neck separately.

Results The prospective readings were 78% accurate overall, 97% accurate in the subset of single-gland disease cases, and 89% accurate in re-exploration cases. There was 91% concordance in interpretation between observers, with κ of 0.83.

Conclusions Initial results after implementation of 4D-CT show high accuracy of interpretation for inexperienced observers, comparable to published data, and high interobserver agreement.

From the Departments of *Radiological Sciences and †Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA; and ‡Imaging Department, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.

Received for publication January 10, 2013; accepted February 6, 2013.

Reprints: Ali R. Sepahdari, MD, Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 757 Westwood Plaza, Suite 1621D, Los Angeles, CA 90095 (e-mail:;

The authors have no financial conflicts of interest to report.

This work was presented at the American Society of Head and Neck Radiology Annual Meeting; October 3–7, 2012; Miami Beach, FL.

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