title: Three-phase parathyroid 4-dimensional computed tomography initial experience: inexperienced readers have high accuracy and high interobserver agreement.
abstract: 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.
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA. asepahdari@mednet.ucla.edu
authors.forename: Ali R
authors.initials: AR
authors.lastname: Sepahdari
authors.forename: Michael W
authors.initials: MW
authors.lastname: Yeh
authors.forename: David
authors.initials: D
authors.lastname: Rodrigues
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Khan
authors.forename: Avital
authors.initials: A
authors.lastname: Harari
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D056973:Four-Dimensional Computed Tomography / Q000379:methods*; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010280:Parathyroid Glands / Q000473:pathology*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity